Folfirinox in locally advanced pancreatic cancer: The massachusetts general hospital cancer center experience

Jason E. Faris, Lawrence S. Blaszkowsky, Shaunagh Mcdermott, Alexander R. Guimaraes, Jackie Szymonifka, Mai Anh Huynh, Cristina R. Ferrone, Jennifer A. Wargo, Jill N. Allen, Lauren E. Dias, Eunice L. Kwak, Keith D. Lillemoe, Sarah P. Thayer, Janet E. Murphy, Andrew X. Zhu, Dushyant V. Sahani, Jennifer Y. Wo, Jeffrey W. Clark, Carlos Fernandez Del Castillo, David P. RyanTheodore S. Hong

Research output: Contribution to journalArticle

161 Citations (Scopus)

Abstract

The objective of our retrospective institutional experience is to report the overall response rate, R0 resection rate, progressionfree survival, and safety/toxicity of neoadjuvant FOLFIRINOX (5- fluorouracil [5-FU], oxaliplatin, irinotecan, and leucovorin) and chemoradiation in patients with locally advanced pancreatic cancer (LAPC). Patients with LAPC treated with FOLFIRINOX were identified via the Massachusetts General Hospital Cancer Center pharmacy database. Demographic information, clinical characteristics, and safety/tolerability data were compiled. Formal radiographic review was performed to determineoverall response rates (ORRs). Twenty-two patients with LAPC began treatment with FOLFIRINOX between July 2010 and February 2012. The ORR was 27.3%, and the median progression- free survival was 11.7 months. Five of 22 patients were able to undergo R0 resections following neoadjuvant FOLFIRINOX and chemoradiation. Three of the five patients have experienced distant recurrence within 5 months. Thirtytwo percent of patients required at least one emergency department visit or hospitalization while being treated with FOLFIRINOX. FOLFIRINOX possesses substantial activity in patients with LAPC. The use of FOLFIRINOX was associated with conversion to resectability in>20% of patients. However, the recurrences following R0 resection in three of five patients and the toxicities observed with the use of this regimen raise important questions about how to best treat patients with LAPC.

Original languageEnglish (US)
Pages (from-to)543-548
Number of pages6
JournalOncologist
Volume18
Issue number5
DOIs
StatePublished - May 1 2013

Fingerprint

Pancreatic Neoplasms
General Hospitals
Neoplasms
oxaliplatin
irinotecan
Safety
Recurrence
Leucovorin
Fluorouracil
Disease-Free Survival
Hospital Emergency Service
Hospitalization
Survival Rate
Demography
Databases

Keywords

  • Chemoradiation
  • FOLFIRINOX
  • Locally advanced pancreatic cancer
  • Neoadjuvant
  • R0 resection

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Faris, J. E., Blaszkowsky, L. S., Mcdermott, S., Guimaraes, A. R., Szymonifka, J., Huynh, M. A., ... Hong, T. S. (2013). Folfirinox in locally advanced pancreatic cancer: The massachusetts general hospital cancer center experience. Oncologist, 18(5), 543-548. https://doi.org/10.1634/theoncologist.2012-0435

Folfirinox in locally advanced pancreatic cancer : The massachusetts general hospital cancer center experience. / Faris, Jason E.; Blaszkowsky, Lawrence S.; Mcdermott, Shaunagh; Guimaraes, Alexander R.; Szymonifka, Jackie; Huynh, Mai Anh; Ferrone, Cristina R.; Wargo, Jennifer A.; Allen, Jill N.; Dias, Lauren E.; Kwak, Eunice L.; Lillemoe, Keith D.; Thayer, Sarah P.; Murphy, Janet E.; Zhu, Andrew X.; Sahani, Dushyant V.; Wo, Jennifer Y.; Clark, Jeffrey W.; Castillo, Carlos Fernandez Del; Ryan, David P.; Hong, Theodore S.

In: Oncologist, Vol. 18, No. 5, 01.05.2013, p. 543-548.

Research output: Contribution to journalArticle

Faris, JE, Blaszkowsky, LS, Mcdermott, S, Guimaraes, AR, Szymonifka, J, Huynh, MA, Ferrone, CR, Wargo, JA, Allen, JN, Dias, LE, Kwak, EL, Lillemoe, KD, Thayer, SP, Murphy, JE, Zhu, AX, Sahani, DV, Wo, JY, Clark, JW, Castillo, CFD, Ryan, DP & Hong, TS 2013, 'Folfirinox in locally advanced pancreatic cancer: The massachusetts general hospital cancer center experience', Oncologist, vol. 18, no. 5, pp. 543-548. https://doi.org/10.1634/theoncologist.2012-0435
Faris JE, Blaszkowsky LS, Mcdermott S, Guimaraes AR, Szymonifka J, Huynh MA et al. Folfirinox in locally advanced pancreatic cancer: The massachusetts general hospital cancer center experience. Oncologist. 2013 May 1;18(5):543-548. https://doi.org/10.1634/theoncologist.2012-0435
Faris, Jason E. ; Blaszkowsky, Lawrence S. ; Mcdermott, Shaunagh ; Guimaraes, Alexander R. ; Szymonifka, Jackie ; Huynh, Mai Anh ; Ferrone, Cristina R. ; Wargo, Jennifer A. ; Allen, Jill N. ; Dias, Lauren E. ; Kwak, Eunice L. ; Lillemoe, Keith D. ; Thayer, Sarah P. ; Murphy, Janet E. ; Zhu, Andrew X. ; Sahani, Dushyant V. ; Wo, Jennifer Y. ; Clark, Jeffrey W. ; Castillo, Carlos Fernandez Del ; Ryan, David P. ; Hong, Theodore S. / Folfirinox in locally advanced pancreatic cancer : The massachusetts general hospital cancer center experience. In: Oncologist. 2013 ; Vol. 18, No. 5. pp. 543-548.
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