Thierry Conroy, MD, medical oncologist, director, Institut de Cancerologie de Lorraine, discusses the findings with an adjuvant a modified FOLFIRINOX (mFOLFIRINOX) regimen in patients with nonmetastatic pancreatic ductal adenocarcinoma.

In a study of 493 patients from 77 centers in Canada and France, the PRODIGE 24/CCTG PA.6 trial evaluated mFOLFIRINOX compared with standard gemcitabine. Phase III findings showed the median overall survival with mFOLFIRINOX was 54.4 versus 35.0 months with gemcitabine, representing a 36% reduction in the risk of death (HR, 0.64; 95% CI, 0.48-0.86; 

The median follow-up was 43.6 months, which Conroy says is due to the fact that an independent data monitoring committee decided that the results had to be presented and published as soon as possible for ethical reasons.

Findings deemed mFOLFIRINOX a safe regimen, but it did have more toxicities than gemcitabine, Conroy says. A higher rate of diarrhea, mucositis, hand-foot syndrome, and grade 3 fatigue were observed in the mFOLFIRINOX arm, while patients who received gemcitabine had more thrombocytopenia, headache, flu-like symptoms, and transaminase elevation.

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Thierry Conroy, MD, medical oncologist, director, Institut de Cancerologie de Lorraine, discusses the findings with an adjuvant a modified FOLFIRINOX regimen in patients with nonmetastatic pancreatic ductal adenocarcinoma.
 

Dr. Conroy on the Findings With Adjuvant mFOLFIRINOX in Pancreatic Cancer

Thierry Conroy, MD, medical oncologist, director, Institut de Cancerologie de Lorraine, discusses survival data with modified FOLFIRINOX (mFOLFIRINOX) in pancreatic cancer.

Investigators suggest that recent phase III findings of mFOLFIRINOX in patients with resected pancreatic cancer have solidified a new adjuvant standard of care for patients who are fit enough to undergo the chemotherapy combination after surgery.

Conroy says that disease-free survival (DFS) was the main objective of the trial, and there was a very important increase in favor of patients treated with mFOLFIRINOX. The median DFS for patients treated with mFOLFIRINOX was 21.6 months compared with 12.8 months with gemcitabine (HR, 0.58; 95% CI, 0.46-0.73; 

 <.001) at a follow-up of 33.6 months. At 3 years, the DFS was 39.7% with mFOLFIRINOX and 21.4% with gemcitabine.

There was also an over 40% reduction in the rate of metastases with mFOLFIRINOX, Conroy says. The median overall survival was almost 20 months longer than with gemcitabine at 54.4 versus 35.0 months. This represents at 36% reduction in the risk of death (HR, 0.64; 95% CI, 0.48-0.86; 

Thierry Conroy, MD, medical oncologist, director, Institut de Cancerologie de Lorraine, discusses survival data with modified FOLFIRINOX in pancreatic cancer.

Dr. Conroy Discusses Survival Data With FOLFIRINOX in Pancreatic Cancer

Thierry Conroy, MD, medical oncologist, director, Institut de Cancerologie de Lorraine, discusses the results of an adjuvant modified FOLFIRINOX regimen (mFOLFIRINOX) in patients with pancreatic cancer.

When given postoperatively, the 4-drug combination of mFOLFIRINOX improved survival compared with standard gemicatbine. Phase III findings presented at the 2018 ASCO Annual Meeting showed that median overall survival (OS) was nearly 20 months longer with a mFOLFIRINOX than with gemcitabine. Median OS with mFOLFIRINOX was 54.4 versus 35.0 months with gemcitabine, which represents a 36% reduction in the risk of death (HR, 0.64; 95% CI, 0.48-0.86; 

Following surgical resection, patients were randomized to receive either mFOLFIRINOX or gemcitabine for 6 months. The mFOLFIRINOX regimen was administered intravenously (IV) at day 1, followed by 5-fluorouracil via continuous IV infusion over 46 hours, for 12 two-week cycles. Gemcitabine was administered via IV on days 1, 8, and 15 every 28 days for 6 cycles.

In light of these results, investigators say that mFOLFIRINOX should be the new adjuvant standard of care for patients who are fit enough to undergo chemotherapy following surgical resection. Conroy says that although mFOLFIRINOX was more toxic than gemcitabine, it is still a safe regimen with manageable toxicities.

Thierry Conroy, MD, medical oncologist, director, Institut de Cancerologie de Lorraine, discusses the results of an adjuvant modified FOLFIRINOX regimen (mFOLFIRINOX) in patients with pancreatic cancer.
 

Thierry Conroy, MD

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Dr. Conroy on the Findings With Adjuvant mFOLFIRINOX in Pancreatic Cancer

Dr. Conroy Discusses Survival Data With FOLFIRINOX in Pancreatic Cancer

Dr. Conroy Discusses Adjuvant mFOLFIRINOX in Pancreatic Cancer