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FOLFIRINOX or Gemcitabine-based Chemotherapy for Borderline Resectable and Locally Advanced Pancreatic Cancer: A
Dilmurodjon Eshmuminov1, Botirjon Aminjonov1, Russell F Palm2
1Department of Surgery and Transplantation, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
Annals of Surgical Oncology
|April 5, 2023
Summary
For unresectable pancreatic cancer, FOLFIRINOX (FIO) chemotherapy offers improved survival over gemcitabine-based regimens. For resectable cases, outcomes are similar between FOLFIRINOX and gemcitabine-based treatments in the neoadjuvant setting.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Medical Oncology
Background:
- Pancreatic cancer, particularly locally advanced (LAPC) and borderline resectable (BRPC) forms, frequently requires neoadjuvant systemic therapy.
- Optimal chemotherapy choice for BRPC and LAPC remains an area of active investigation.
Approach:
- A systematic review and multi-institutional meta-analysis of patient-level data were conducted.
- The analysis compared FOLFIRINOX (FIO) with various gemcitabine-based chemotherapy regimens for BRPC and LAPC.
Key Points:
- FOLFIRINOX (FIO) demonstrated superior overall survival (OS) compared to gemcitabine-based therapies in unresectable BRPC and LAPC patients.
- Resection rates were comparable between FIO and gemcitabine-based regimens for BRPC and LAPC.
- In patients who underwent surgical resection, OS was similar across different neoadjuvant chemotherapy regimens (FIO, gemcitabine/nab-paclitaxel, GemX, gemcitabine monotherapy).
Conclusions:
- Neoadjuvant FOLFIRINOX (FIO) may offer a survival advantage for unresectable pancreatic cancer (BRPC/LAPC) compared to gemcitabine-based chemotherapy.
- For patients undergoing surgical resection, neoadjuvant FOLFIRINOX and gemcitabine-based regimens yield similar survival outcomes.
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