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Do Women Respond More Favorably Than Men to the FOLFIRINOX Regimen in Advanced Pancreatic Cancer ?

We have come across an interesting recent finding from researchers in Austria.

Greil and colleagues from the Paracelsus Medical University in Salzburg, have published the results of their work in the January 2014 issue of the International Journal of Oncology. These findings appear to suggest that the female gender may be a predictor of a positive response to the four-drug regimen known as FOLFIRINOX in the treatment of advanced pancreatic cancer (ductal adenocarcinoma of the pancreas).

The researchers undertook a retrospective analysis of 49 patients with unresectable cancer of the pancreas who were treated with FOLFIRINOX.  This included 24 females and 25 males. Although the overall median survival duration of women in this study was not found to be significantly different than the men (15 months vs. 12 months) the women’s progression-free survival, response rates and disease control rates in pancreatic cancer were significantly improved over their male counterparts.  This was a surprising finding.

The demographics of the females appeared fairly well matched compared that of the males, although the women showed higher levels of CA 19-9, CEA, Ki-67 and mutated p53 cells.  Also perhaps significantly, the women demonstrated more stage 3 tumors and many less stage 4 then the men.   Finally, the authors point to the increased number of non-metastatic locally advanced tumors in the male patients versus the females (6 vs. 0) with the idea that these may have nullified the advantage conferred by women having a higher response rate.

Still, this is an intriguing result worthy of further inquiry.

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Dale O’Brien, MD