首页|FOLFIRI regimen in metastatic pancreatic adenocarcinoma resistant to gemcitabine and platinum-salts

FOLFIRI regimen in metastatic pancreatic adenocarcinoma resistant to gemcitabine and platinum-salts

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AIM:To evaluate the efficacy and safety of the FOLFIRI regimen in patients with metastatic pancreatic adenocarcinoma (PAC) after the failure of gemcitabine and platinum salts.METHODS:All consecutive patients with histologically confirmed,metastatic PAC and World Health Organization performance status (PS) ≤ 2 received FOLFIRI-1 [irinotecan 180 mg/m2 on day 1 and leucovorin 400 mg/m2 followed by 5-fluorouracil (5-FU) 400 mg/m2 bolus,then 5-FU 2400 mg/m2 as a 46-h infusion,biweekly] or FOLFIRI-3 (irinotecan 100 mg/m2 on day 1 and leucovorin 400 mg/m2,then 5-FU 2400 mg/m2 as a 46-h infusion and irinotecan 100 mg/m2 repeated on day 3,biweekly) after failure of gemcitabine and platinum-based chemotherapies as a systematic policy in two institutions between January 2005 and May 2010.Tumor response,time to progression (TTP),overall survival rate (OS) and grade 3-4 toxicities were retrospectively studied.Subgroup analyses were performed to search for prognostic factors.RESULTS:Sixty-three patients (52.4％ male,median age 59 years) were analyzed.Among them,42.9％ were PS 0,38.1％ were PS 1 and 19.0％ were PS 2.Fifty one patients (81.0％) had liver metastases.Before the FOLFIRI regimen,patients had received 1 line (n =19),2 lines (n =39) or 3 lines (n =5) of chemotherapy.Median TTP obtained with the line before FOLFIRI was 3.9 mo (95％ CI:3.4-5.3 mo).A total of 480 cycles was completed (median:6 cycles,range:1-51 cycles).The main reason for discontinuing FOLFIRI was tumor progression (90.3％).Tumor control was achieved in 25 patients (39.7％) (partial response:n =5,stable disease:n =20) with FOLFIRI.Median TTP was 3.0 mo (95％ CI:2.1-3.9 mo) and median OS was 6.6 mo (95％ CI:5.3-8.1 mo).Dose adaptation was required in 36 patients (57.1％).Fifteen patients (23.8％) had grade 3-4 toxicities,mainly hematological (n =11) or digestive (n =4).Febrile neutropenia occurred in 3 patients.There was no toxic death.PS 2 was significantly associated with poor TTP [hazard ratio (HR):16.036,P ＜ 0.0001) and OS (HR:4.003,P =0.004].CONCLUSION:The FOLFIRI regimen had an acceptable toxicity and an interesting efficacy in our study,limited to patients in good condition (PS 0-1).

Pancreatic cancerPancreatic adenocarcinomaMetastasesChemotherapy5-fluorouracilIrinotecanCamptothecinFOLFIRI regimen

Cindy Neuzillet、Olivia Hentic、Beno(i)t Rousseau、Vinciane Rebours、Lé(i)la Bengrine-Lefèvre、Franck Bonnetain、Philippe Lévy

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Service de Gastroentérologie-Pancréatologie, H(o)pital Beaujon, 100 Boulevard du Général Leclerc, 92110 Clichy La Garenne, AP-HP,France

Service d'Oncologie Médicale, H(o)pital Saint Antoine, 184 Rue du Faubourg Saint-Antoine, 75012 Paris, AP-HP, France

Unité de Biostatistique et d'Epidémiologie EA 4184, Centre Georges Fran(c)is Leclerc, 1 Rue du Pr Marion, 21079 Dijon, France

2012

10.3748/wjg.v18.i33.4533

世界胃肠病学杂志(英文版)
太原消化病研治中心

世界胃肠病学杂志(英文版)

SCI
影响因子：1.001
ISSN：1007-9327
年,卷(期)：2012.18(33)
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