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FOLFIRINOX (Minus Irinotecan) for Gemcitabine-refractory Pancreatic Cancer

Since the promising article on the 4-drug 5-FU led FOLFIRINOX regimen for metastatic pancreatic cancer (ductal adenocarcinoma of the pancreas) per the May 12, 2011 article in the New England Journal of Medicine, this treatment approach has emerged as a solid first-line option.  In the ensuing months there have been a number of studies exploring further options with this 4-drug combination, including for other stages in cancer of the pancreas.

Now comes interesting research by Wahba and El-Hadaad of Mansoura University, Egypt as published in the September 2013 issue of the Journal of Gastrointestinal Cancer looking at a somewhat truncated version of this regimen in patients whose advanced pancreatic cancer showed progression after treatment with gemcitabine.

In a phase 2 clinical trial, the authors treated thirty such patients with a regimen that included 5-FU (fluorouacil), folinic acid, and oxaliplatin (the FOLFIRINOX regimen without irinotecan) with tolerable (adjudged) side-effects and a median overall survival of 22 weeks, and a six-month survival rate of 30%. They conclude that this regimen is active and in need of further study.

We concur. Very interesting work – that would benefit by follow-up research.

More here

 

Dale O’Brien, MD

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