Dr. Conroy Discusses Adjuvant mFOLFIRINOX in Pancreatic Cancer

Thierry Conroy, MD, medical oncologist, director, Institut de Cancerologie de Lorraine, discusses the results of an adjuvant modified FOLFIRINOX regimen (mFOLFIRINOX) in patients with pancreatic cancer.

When given postoperatively, the 4-drug combination of mFOLFIRINOX improved survival compared with standard gemicatbine. Phase III findings presented at the 2018 ASCO Annual Meeting showed that median overall survival (OS) was nearly 20 months longer with a mFOLFIRINOX than with gemcitabine. Median OS with mFOLFIRINOX was 54.4 versus 35.0 months with gemcitabine, which represents a 36% reduction in the risk of death (HR, 0.64; 95% CI, 0.48-0.86; P = .003).

Following surgical resection, patients were randomized to receive either mFOLFIRINOX or gemcitabine for 6 months. The mFOLFIRINOX regimen was administered intravenously (IV) at day 1, followed by 5-fluorouracil via continuous IV infusion over 46 hours, for 12 two-week cycles. Gemcitabine was administered via IV on days 1, 8, and 15 every 28 days for 6 cycles.

In light of these results, investigators say that mFOLFIRINOX should be the new adjuvant standard of care for patients who are fit enough to undergo chemotherapy following surgical resection. Conroy says that although mFOLFIRINOX was more toxic than gemcitabine, it is still a safe regimen with manageable toxicities.