First-line FOLFIRINOX (leucovorin, fluorouracil, irinotecan, oxaliplatin) is associated with median overall survival of approximately 2 years in patients with locally advanced pancreatic cancer, according to a systematic review and patient-level meta-analysis reported by Suker et al in The Lancet Oncology.
The patient-level meta-analysis included 315 patients from 11 studies reporting survival outcomes. Median overall survival from the start of FOLFIRINOX ranged from 10.0 months to 32.7 months across studies, with a pooled patient-level median overall survival of 24.2 months (95% confidence interval [CI] = 21.7–26.8 months). Median progression-free survival ranged from 3.0 to 20.4 months, with a patient-level median progression-free survival of 15.0 months (95% CI = 13.8–16.2 months).
The proportions of patients who underwent radiotherapy or chemoradiotherapy ranged from 31% to 100% across studies, the proportion who underwent resection ranged from 0% to 43%, and the proportion of those with R0 resection ranged from 50% to 100%.
The investigators concluded: “Patients with locally advanced pancreatic cancer treated with FOLFIRINOX had a median overall survival of 24.2 months—longer than that reported with gemcitabine (6–13 months). Future research should assess these promising results in a randomised controlled trial and should establish which patients might benefit from radiotherapy or chemoradiotherapy or resection after FOLFIRINOX.”
Bas Groot Koerkamp, MD, of Erasmus University Medical Center, Rotterdam, Netherlands, is the corresponding author of The Lancet Oncology article.
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