First-Line Modified FOLFIRINOX in Metastatic Pancreatic Cancer: Real-World Outcomes and Prognostic Factors From a...

Area of Science:

• Oncology
• Gastroenterology
• Clinical Research

Background:

• Metastatic pancreatic cancer has a poor prognosis despite chemotherapy.
• Real-world data on modified FOLFIRINOX (mFOLFIRINOX) in low-resource settings are limited.
• This study focuses on Vietnamese patients receiving mFOLFIRINOX as first-line treatment.

Purpose of the Study:

• To evaluate the efficacy and toxicity of mFOLFIRINOX in Vietnamese patients with metastatic pancreatic cancer.
• To identify prognostic factors influencing outcomes in this population.
• To assess the feasibility of mFOLFIRINOX in a real-world, low-resource healthcare system.

Main Methods:

• Retrospective cohort study of 36 patients receiving mFOLFIRINOX.
• Peg-filgrastim used for prophylaxis; flexible treatment interruptions allowed.
• Assessment of progression-free survival (PFS), overall survival (OS), tumor response, and adverse events.
• Prognostic factor analysis using log-rank tests and Cox regression.

Main Results:

• Median follow-up was 15.6 months.
• Overall response rate (ORR) was 30.6%; disease control rate (DCR) was 66.6%.
• Median PFS was 6.7 months; median OS was 12.5 months.
• Grade 3/4 hematologic toxicities (neutropenia, anemia) were observed; no febrile neutropenia.
• Performance status (PS) and age < 60 were associated with better outcomes; PS was an independent prognostic factor for OS.

Conclusions:

• The mFOLFIRINOX regimen is effective and manageable in Vietnamese patients with metastatic pancreatic cancer.
• An individualized treatment approach with interruptions correlated with favorable outcomes.
• Findings support the feasibility of mFOLFIRINOX in real-world, resource-limited settings.