5-Fluorouracil/L-Leucovorin Plus Oxaliplatin (FOLFOX) Regimen as Salvage Chemotherapy for Patients with Unresectable Pancreatic Cancer Receiving Gemcitabine and Nab-Paclitaxel and 5-Fluorouracil/L-Leucovorin Plus Nanoliposomal Irinotecan: Preliminary Results from Clinical Practice

• Published in: Current oncology (Toronto) Vol. 29; no. 4; pp. 2644 - 2649
• Main Authors: Yamai, Takuo, Ikezawa, Kenji, Kawamoto, Yasuharu, Hirao, Takeru, Higashi, Sena, Daiku, Kazuma, Maeda, Shingo, Abe, Yutaro, Urabe, Makiko, Kai, Yugo, Takada, Ryoji, Nakabori, Tasuku, Uehara, Hiroyuki, Ohkawa, Kazuyoshi
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI 11-04-2022; MDPI AG
• Subjects: Albumins; Antineoplastic Combined Chemotherapy Protocols; chemotherapy; Communication; Deoxycytidine - analogs & derivatives; Fluorouracil - therapeutic use; FOLFOX; Gemcitabine; Humans; Irinotecan - pharmacology; Irinotecan - therapeutic use; Leucovorin - therapeutic use; Oxaliplatin - pharmacology; Oxaliplatin - therapeutic use; Paclitaxel; pancreatic cancer; Pancreatic Neoplasms; Retrospective Studies; FOLFOX; chemotherapy; pancreatic cancer
• ISSN: 1718-7729; 1198-0052; 1718-7729
• DOI: 10.3390/curroncol29040216

Salvage chemotherapy for patients with unresectable pancreatic cancer (UR-PC) who have been treated with gemcitabine and nab-paclitaxel (GnP), and 5-fluorouracil (5-FU)/l-leucovorin (LV) plus nanoliposomal irinotecan (nal-IRI), has not been fully established. We retrospectively reviewed data from 17 patients with UR-PC who initiated 5-FU/l-LV plus oxaliplatin (FOLFOX) as salvage chemotherapy at our hospital between June 2020 and August 2021, after treatment with GnP and 5-FU/LV plus nal-IRI. The primary endpoint was tumor response. The secondary endpoints were progression-free survival (PFS) and adverse events (AEs). The response and disease control rates were 5.9% (1/17) and 17.6% (3/17), respectively. The median PFS was 1.8 months (range: 0.4-5.2 months). Eight patients (47.1%) experienced grade 3 nonhematologic AEs, while none experienced grade 3 hematologic AEs. Two patients with controlled disease had homologous recombination deficiency (HRD)-associated gene mutations in cancer panel testing. The FOLFOX regimen benefit for UR-PC patients treated with GnP and 5-FU/LV plus nal-IRI may be limited to patients with HRD-associated gene mutations.