Journal article
Neoadjuvant-modified FOLFIRINOX vs nab-paclitaxel plus gemcitabine for borderline resectable or locally advanced pancreatic cancer patients who achieved surgical resection
Cancer medicine (Malden, MA), Vol.9(13), pp.4711-4723
07/01/2020
DOI: 10.1002/cam4.3075
PMCID: PMC7333854
PMID: 32415696
Abstract
We conducted an institutional study to compare the clinical and pathological efficacy between the neoadjuvant therapy (NAT)-modified FOLFIRINOX (mFOLF) vs nanoparticle albumin-bound paclitaxel plus gemcitabine (nab-P/G) for borderline resectable pancreatic cancer (BRPC) and locally advanced pancreatic cancer (LAPC) patients who completed resection. The study retrospectively enrolled patients with pathologically confirmed BRPC or LAPC from 2010 to 2018 at our institution. The survival rates were determined by the Kaplan-Meier method and log-rank test was used to test differences. Cox's proportional hazard model was used to assess survival with respect to covariates. Seventy-two patients who completed at least two cycles of neoadjuvant chemotherapy and surgical resection were included, with 52 (72.2%) patients receiving mFOLF and 20 (27.8%) receiving nab-P/G. Patients treated with mFOLF had statistically higher rates of RECIST 1.1 partial or complete response (16/52 vs 1/20, P = .028). Additionally, mFOLF patients had greater pathological tumor size reduction, fewer positive lymph nodes, and higher treatment response grade compared to the nab-P/G patients (all P < .05). The median overall survival was 33.3 months vs 27.1 months (P = .105), and distant metastasis-free survival (DMFS) was 21.3 months vs 14.6 months (P = .042) in the mFOLF vs nab-P/G groups, respectively. On multivariate analysis, mFOLF (hazard ratio, 0.428; 95% confidence interval [CI], 0.186-0.987) and abnormal postoperative CA 19-9 (hazard ratio, 2.47; 95% CI, 1.06-5.76) were associated with DMFS. Among patients with BRPC and LAPC who complete surgical resection, neoadjuvant mFOLF was associated with improved pathological and clinical outcomes compared with nab-P/G.
Details
- Title: Subtitle
- Neoadjuvant-modified FOLFIRINOX vs nab-paclitaxel plus gemcitabine for borderline resectable or locally advanced pancreatic cancer patients who achieved surgical resection
- Creators
- Adam R. Wolfe - The Ohio State UniversityDhivya Prabhakar - The Ohio State UniversityVedat O. Yildiz - The Ohio State UniversityJordan M. Cloyd - The Ohio State UniversityMary Dillhoff - The Ohio State UniversityLaith Abushahin - The Ohio State UniversityDayssy Alexandra Diaz - The Ohio State UniversityEric D. Miller - The Ohio State UniversityWei Chen - The Ohio State UniversityWendy L. Frankel - The Ohio State UniversityAnne Noonan - The Ohio State UniversityTerence M. Williams - The Ohio State University
- Resource Type
- Journal article
- Publication Details
- Cancer medicine (Malden, MA), Vol.9(13), pp.4711-4723
- DOI
- 10.1002/cam4.3075
- PMID
- 32415696
- PMCID
- PMC7333854
- NLM abbreviation
- Cancer Med
- ISSN
- 2045-7634
- eISSN
- 2045-7634
- Publisher
- Wiley
- Number of pages
- 13
- Grant note
- Ohio State University Comprehensive Cancer Center (OSU-CCC) R01 CA198128 / NIH/NCI; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI) P30 CA016058 / National Institute of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA
- Language
- English
- Date published
- 07/01/2020
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9984360154102771
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