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Vol. 59, No. 4, 2013
Issue release date: February 2014
Chemotherapy 2013;59:273-279

5-Fluorouracil/Leucovorin Combined with Irinotecan and Oxaliplatin (FOLFIRINOX) as Second-Line Chemotherapy in Patients with Advanced Pancreatic Cancer Who Have Progressed on Gemcitabine-Based Therapy

Lee M.G. · Lee S.H. · Lee S.J. · Lee Y.S. · Hwang J.-H. · Ryu J.K. · Kim Y.-T. · Kim D.U. · Woo S.M.
aDepartments of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine and bDepartments of Internal Medicine, Seoul National University Hospital, Seoul, cDepartments of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, dDepartment of Internal Medicine, Hanmaeum Hospital, Jeju, eDepartment of Internal Medicine, Pusan National University School of Medicine, Busan, fCenter for Liver Cancer, National Cancer Center, Goyang, Korea

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Background/Aims: There is no standard consensus on a strategy in the second-line setting for gemcitabine-refractory advanced pancreatic cancer. This study evaluated the activity and tolerability of oxaliplatin, irinotecan, 5-fluorouracil and leucovorin (FOLFIRINOX) as a second-line therapy in advanced pancreatic adenocarcinoma pretreated with a gemcitabine-based regimen. Methods: A retrospective survey was carried out on 18 patients with advanced pancreatic cancer who had been on gemcitabine-based chemotherapy and were then treated with FOLFIRINOX as a second-line therapy. Results: One patient (5.6%) had a confirmed complete response, 4 (22.2%) had confirmed partial responses and 5 (27.8%) had stable disease, resulting in a rate of disease control of 55.6% (95% CI, 33.3-77.8%). The median progression-free survival and median survival were 2.8 months and 8.4 months, respectively. Seven patients (38.9%) experienced grade 3-4 neutropenia. Grade 3 or 4 nonhematologic adverse events included nausea (38.9%) and vomiting (16.7%). Conclusions: These results suggest the modest clinical activity regarding efficacy and the acceptable toxicity profile with the FOLFIRINOX regimen as a second-line treatment. © 2014 S. Karger AG, Basel

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