- Fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX) may lead to more pancreatectomies than gemcitabine plus nab-paclitaxel in localized pancreatic ductal adenocarcinoma (PDAC).
- Survival does not differ between the two.
Why this matters
- FOLFIRINOX might be the best choice for patients with localized PDAC who have no contraindications and are deemed likely to tolerate the regimen’s toxicity profile.
- Single-institution propensity-score-matched analysis (N=485).
- Funding: NIH.
- Patients in the FOLFIRINOX group were younger (median age, 61 vs 71 years; P=.001) and more frequently had Eastern Cooperative Oncology Group scale scores ≤2 (96% vs 82%; P=.001).
- FOLFIRINOX recipients more often had invasive tumors (32% resectable vs 45% resectable; P=.01).
- After propensity score matching, Response Evaluation Criteria in Solid Tumors partial response occurred more often in the FOLFIRINOX group (19% vs 6%; P=.001).
- The FOLFIRINOX group more often underwent radiation/chemoradiation (53% vs 34%; P=.001) and was more likely to undergo pancreatectomy (27% vs 16%; P=.01).
- There was no significant difference between the regimens in OS.
- The study needs to be confirmed prospectively.