Comparison of Adjuvant Modified FOLFIRINOX with Other Adjuvant Chemotherapies in Resected Pancreatic Adenocarcinoma: Real-life Data

Yıl: 2023 Cilt: 56 Sayı: 2 Sayfa Aralığı: 170 - 179 Metin Dili: İngilizce DOI: 10.5505/aot.2023.41196 İndeks Tarihi: 09-12-2023

Comparison of Adjuvant Modified FOLFIRINOX with Other Adjuvant Chemotherapies in Resected Pancreatic Adenocarcinoma: Real-life Data

Öz:
INTRODUCTION: Pancreatic cancer is among the cancers with the worst prognosis and therefore adjuvant treatment is very important for reducing mortality. The aim of this study is to compare the gold standard mFolfirinox regimen with other treatment regimens in the adjuvant treatment of pancreatic cancer in real-world practice. METHODS: Patients who underwent pancreatic cancer resection and received at least one dose of adjuvant chemotherapy were included in the study as two groups, mFolfirinox and Others (at a ratio of 1: 2). The primary endpoint was disease-free survival (DFS). Secondary endpoints were determined as overall survival (OS), predictive factors, and safety. RESULTS: Data of 166 patients were collected from 5 oncology centers. With a median follow-up of 30.3 months (24.6 - 35.9), the estimated median DFS was detected 17.9 months (95% CI, 10.3 - 25.6) in the mFolfirinox group and 12.5 months (95% CI, 9.7 - 15.3) in the others group (p = 0.088). The estimated median OS was 30.7 months (95% CI, 15.7 - 45.7) in the mFolfirinox group and 22 months (95% CI, 16 - 27.9) in the others group (p = 0.464). Better ECOG performance status, tumor location outside the head and ampulla, stage 1 and 2B, not receiving adjuvant chemoradiotherapy (CRT), and perineural invasion provide a disease-free survival advantage in favor of mFolfirinox. DISCUSSION AND CONCLUSION: In the adjuvant treatment of resected pancreatic cancer, the mFolfirinox regimen provided a statistically insignificant, but clinically significant DFS and OS benefit.
Anahtar Kelime: Pancreatic adenocarcinoma modified folfirinox adjuvant chemotherapy real-life experience

Rezeke Edilmiş Pankreas Adenokarsinomda Adjuvan Modifiye FOLFİRİNOX'un Diğer Adjuvan Kemoterapilerle Karşılaştırılması: Gerçek Yaşam Verisi

Öz:
Amaç: Pankreas kanseri prognozu en kötü olan kanserler arasında yer alır ve bu nedenle adjuvan tedavi mortaliteyi azaltmak için çok önemlidir. Bu çalışmanın amacı, gerçek dünya pratiğinde pankreas kanserinin adjuvan tedavisinde altın standart mFolfirinox rejimini diğer tedavi rejimleriyle karşılaştırmaktır. Gereç ve yöntem: Pankreas kanseri rezeksiyonu yapılan ve en az bir doz adjuvan kemoterapi alan hastalar mFolfirinox ve Diğerleri (1:2 oranında) olmak üzere iki grup olarak çalışmaya alındı. Birincil sonlanım noktası hastalıksız sağkalımdı (DFS). İkincil sonlanım noktaları, genel sağkalım (OS), prediktif faktörler ve güvenlik olarak belirlendi. Bulgular: Beş onkoloji merkezinden 166 hastanın verileri toplandı. Ortanca 30,3 aylık (24,6-35,9) takipte, tahmini ortanca DFS, mFolfirinox grubunda 17,9 ay (%95 GA, 10,3-25,6) ve diğerleri grubunda 12,5 ay (%95 GA, 9,7-15,3) olarak saptandı (p = 0.088). Tahmini ortanca OS, mFolfirinox grubunda 30,7 ay (%95 GA, 15,7-45,7), diğerleri grubunda 22 aydı (%95 GA, 16-27,9) (p=0,464). Daha iyi ECOG performans durumu, tümörün baş ve ampulla dışında yerleşimi, evre 1 ve 2B, adjuvan kemoradyoterapi (CRT) almama ve perinöral invazyon, mFolfirinox lehine hastalıksız sağkalım avantajı sağladı. Sonuç: Rezeke edilmiş pankreas kanserinin adjuvan tedavisinde, mFolfirinox rejimi istatistiksel olarak önemsiz, ancak klinik olarak anlamlı bir DFS ve OS faydası sağladı.
Anahtar Kelime: Pankreas adenokarsinomu modifiye folfirinox adjuvan kemoterapi gerçek yaşam deneyimi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Watson MD, Miller-Ocuin JL, Driedger MR, et al. Factors Associated with Treatment and Survival of Early Stage Pancreatic Cancer in the Era of Modern Chemotherapy: An Analysis of the National Cancer Database. Journal of Pancreat Cancer 2020; 6(1): 85-95.
  • 2. Ilic M, Ilic I. Epidemiology of pancreatic cancer. World Journal of Gastroenterology 2016; 22(44): 9694-9705.
  • 3. O'Kane GM, Ladak F, Gallinger S. Advances in the management of pancreatic ductal adenocarcinoma. Canadian Medical Association Journal 2021; 193(23): E844-E851.
  • 4. Oettle H, Neuhaus P, Hochhaus A, et al. Adjuvant chemotherapy with gemcitabine and long- term outcomes among patients with resected pancreatic cancer: the CONKO-001 randomized trial. Journal of the American Medical Association 2013; 310(14): 1473-81.
  • 5. Neoptolemos JP, Palmer DH, Ghaneh P, et al. Comparison of adjuvant gemcitabine and capecitabine with gemcitabine monotherapy in patients with resected pancreatic cancer (ESPAC-4): a multicentre, open-label, randomised, phase 3 trial. Lancet 2017; 389(10073): 1011-1024..
  • 6. Tempero MA, Pelzer U, O'Reilly EM, et al. Adjuvant nab-Paclitaxel + Gemcitabine in Resected Pancreatic Ductal Adenocarcinoma: Results From a Randomized, Open-Label, Phase III Trial. J Clin Oncol. 2023; 41: 2007-19.
  • 7. Conroy T, Desseigne F, Ychou M, et al. FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. New England Journal of Medicine 2011; 364(19): 1817-25.
  • 8. Conroy T, Hammel P, Hebbar M, et al. FOLFIRINOX or Gemcitabine as Adjuvant Therapy for Pancreatic Cancer. New England Journal of Medicine 2018; 379(25): 2395-2406.
  • 9. Abdel-Rahman O, Xu Y, Tang PA, Lee-Ying RM, Cheung WY. A real-world, population-based study of patterns of referral, treatment, and outcomes for advanced pancreatic cancer. Cancer Medicine 2018; 7(12): 6385-6392.
  • 10. Ryan DP, Hong TS, Bardeesy N. Pancreatic adenocarcinoma. New England Journal of Medicine 2014; 371(11): 1039-49.
  • 11. Tonini V, Zanni M. Pancreatic cancer in 2021: What you need to know to win. World Journal of Gastroenterology 2021; 27(35): 5851-5889.
  • 12. Fenocchio E, Filippi R, Lombardi P, et al. Is There a Standard Adjuvant Therapy for Resected Pancreatic Cancer? Cancers (Basel) 2019; 11(10).
  • 13. Varol U, Uzum Y, Sengul A, et al. An analysis of adjuvant treatment strategies in operated pancreatic cancer patients: An Izmir oncology group study. Indian Journal of Cancer 2020; 57(2): 158- 163.
  • 14. de Jesus VHF, Riechelmann RP. Comparative efficacy of modified FOLFIRINOX, gemcitabine plus capecitabine and gemcitabine plus nab-paclitaxel as adjuvant treatment for resected pancreatic cancer: a Bayesian network meta- analysis. Ecancermedicalscience 2021; 15: 1276.
  • 15. Neoptolemos JP, Stocken DD, Friess H, et al. A randomized trial of chemoradiotherapy and chemotherapy after resection of pancreatic cancer. New England Journal of Medicine 2004; 350(12): 1200-10.
  • 16. Oettle H, Post S, Neuhaus P, et al. Adjuvant chemotherapy with gemcitabine vs observation in patients undergoing curative-intent resection of pancreatic cancer: a randomized controlled trial. Journal of the American Medical Association 2007; 297(3): 267-77.
  • 17. Chikhladze S, Lederer AK, Kousoulas L, et al. Adjuvant chemotherapy after surgery for pancreatic ductal adenocarcinoma: retrospective real-life data. World Journal of Surgical Oncology 2019; 17(1): 185.
  • 18. Abdel-Rahman O, Spratlin J, Koski S. Real- world patterns of adjuvant chemotherapy treatment for patients with resected pancreatic adenocarcinoma. Medical Oncology 2021; 38(2): 18.
  • 19. Conroy T, Castan F, Lopez A, et al. Five-Year Outcomes of FOLFIRINOX vs Gemcitabine as Adjuvant Therapy for Pancreatic Cancer: A Randomized Clinical Trial. Journal of the American Medical Association 2022; 8(11):1571-1578.
  • 20. Muhammadzai J, Haider K, Moser M, et al. Early discontinuation of adjuvant chemotherapy in patients with early-stage pancreatic cancer correlates with inferior survival: A multicenter population-based cohort study. PLoS One 2022; 17(2): e0263250.
  • 21. Turrini O, Paye F, Bachellier P, et al. Pancreatectomy for adenocarcinoma in elderly patients: postoperative outcomes and long term results: a study of the French Surgical Association. European Journal of Surgical Oncology 2013; 39(2): 171-8.
  • 22. Gajda M, Kenig J. Treatment outcomes of pancreatic cancer in the elderly - literature review. Folia Medica Cracoviensia 2018; 58(3): 49-66.
  • 23. Yao L, Tang C, Feng W, Dai H. A Single- Center Retrospective Study to Compare the Efficacy and Safety of Modified FOLFIRINOX with S-1 as Adjuvant Chemotherapy in 71 Patients with Resected Pancreatic Carcinoma. Medical Science Monitor 2022; 28: e937136.
APA EROL C, HAFIZOĞLU E, aykan m, Guven D, Dursun B, Hizal M, kahraman s, sener dede d, Akinci M, Karadurmuş N, ÜRÜN Y, ALGIN E, yalcin s, yalcin b, Sendur M (2023). Comparison of Adjuvant Modified FOLFIRINOX with Other Adjuvant Chemotherapies in Resected Pancreatic Adenocarcinoma: Real-life Data. , 170 - 179. 10.5505/aot.2023.41196
Chicago EROL CİHAN,HAFIZOĞLU EMRE,aykan musa baris,Guven Deniz Can,Dursun Bengu,Hizal Mutlu,kahraman seda,sener dede didem,Akinci Muhammed Bulent,Karadurmuş Nuri,ÜRÜN YÜKSEL,ALGIN EFNAN,yalcin suayib,yalcin bulent,Sendur Mehmet Comparison of Adjuvant Modified FOLFIRINOX with Other Adjuvant Chemotherapies in Resected Pancreatic Adenocarcinoma: Real-life Data. (2023): 170 - 179. 10.5505/aot.2023.41196
MLA EROL CİHAN,HAFIZOĞLU EMRE,aykan musa baris,Guven Deniz Can,Dursun Bengu,Hizal Mutlu,kahraman seda,sener dede didem,Akinci Muhammed Bulent,Karadurmuş Nuri,ÜRÜN YÜKSEL,ALGIN EFNAN,yalcin suayib,yalcin bulent,Sendur Mehmet Comparison of Adjuvant Modified FOLFIRINOX with Other Adjuvant Chemotherapies in Resected Pancreatic Adenocarcinoma: Real-life Data. , 2023, ss.170 - 179. 10.5505/aot.2023.41196
AMA EROL C,HAFIZOĞLU E,aykan m,Guven D,Dursun B,Hizal M,kahraman s,sener dede d,Akinci M,Karadurmuş N,ÜRÜN Y,ALGIN E,yalcin s,yalcin b,Sendur M Comparison of Adjuvant Modified FOLFIRINOX with Other Adjuvant Chemotherapies in Resected Pancreatic Adenocarcinoma: Real-life Data. . 2023; 170 - 179. 10.5505/aot.2023.41196
Vancouver EROL C,HAFIZOĞLU E,aykan m,Guven D,Dursun B,Hizal M,kahraman s,sener dede d,Akinci M,Karadurmuş N,ÜRÜN Y,ALGIN E,yalcin s,yalcin b,Sendur M Comparison of Adjuvant Modified FOLFIRINOX with Other Adjuvant Chemotherapies in Resected Pancreatic Adenocarcinoma: Real-life Data. . 2023; 170 - 179. 10.5505/aot.2023.41196
IEEE EROL C,HAFIZOĞLU E,aykan m,Guven D,Dursun B,Hizal M,kahraman s,sener dede d,Akinci M,Karadurmuş N,ÜRÜN Y,ALGIN E,yalcin s,yalcin b,Sendur M "Comparison of Adjuvant Modified FOLFIRINOX with Other Adjuvant Chemotherapies in Resected Pancreatic Adenocarcinoma: Real-life Data." , ss.170 - 179, 2023. 10.5505/aot.2023.41196
ISNAD EROL, CİHAN vd. "Comparison of Adjuvant Modified FOLFIRINOX with Other Adjuvant Chemotherapies in Resected Pancreatic Adenocarcinoma: Real-life Data". (2023), 170-179. https://doi.org/10.5505/aot.2023.41196
APA EROL C, HAFIZOĞLU E, aykan m, Guven D, Dursun B, Hizal M, kahraman s, sener dede d, Akinci M, Karadurmuş N, ÜRÜN Y, ALGIN E, yalcin s, yalcin b, Sendur M (2023). Comparison of Adjuvant Modified FOLFIRINOX with Other Adjuvant Chemotherapies in Resected Pancreatic Adenocarcinoma: Real-life Data. ACTA ONCOLOGICA TURCICA, 56(2), 170 - 179. 10.5505/aot.2023.41196
Chicago EROL CİHAN,HAFIZOĞLU EMRE,aykan musa baris,Guven Deniz Can,Dursun Bengu,Hizal Mutlu,kahraman seda,sener dede didem,Akinci Muhammed Bulent,Karadurmuş Nuri,ÜRÜN YÜKSEL,ALGIN EFNAN,yalcin suayib,yalcin bulent,Sendur Mehmet Comparison of Adjuvant Modified FOLFIRINOX with Other Adjuvant Chemotherapies in Resected Pancreatic Adenocarcinoma: Real-life Data. ACTA ONCOLOGICA TURCICA 56, no.2 (2023): 170 - 179. 10.5505/aot.2023.41196
MLA EROL CİHAN,HAFIZOĞLU EMRE,aykan musa baris,Guven Deniz Can,Dursun Bengu,Hizal Mutlu,kahraman seda,sener dede didem,Akinci Muhammed Bulent,Karadurmuş Nuri,ÜRÜN YÜKSEL,ALGIN EFNAN,yalcin suayib,yalcin bulent,Sendur Mehmet Comparison of Adjuvant Modified FOLFIRINOX with Other Adjuvant Chemotherapies in Resected Pancreatic Adenocarcinoma: Real-life Data. ACTA ONCOLOGICA TURCICA, vol.56, no.2, 2023, ss.170 - 179. 10.5505/aot.2023.41196
AMA EROL C,HAFIZOĞLU E,aykan m,Guven D,Dursun B,Hizal M,kahraman s,sener dede d,Akinci M,Karadurmuş N,ÜRÜN Y,ALGIN E,yalcin s,yalcin b,Sendur M Comparison of Adjuvant Modified FOLFIRINOX with Other Adjuvant Chemotherapies in Resected Pancreatic Adenocarcinoma: Real-life Data. ACTA ONCOLOGICA TURCICA. 2023; 56(2): 170 - 179. 10.5505/aot.2023.41196
Vancouver EROL C,HAFIZOĞLU E,aykan m,Guven D,Dursun B,Hizal M,kahraman s,sener dede d,Akinci M,Karadurmuş N,ÜRÜN Y,ALGIN E,yalcin s,yalcin b,Sendur M Comparison of Adjuvant Modified FOLFIRINOX with Other Adjuvant Chemotherapies in Resected Pancreatic Adenocarcinoma: Real-life Data. ACTA ONCOLOGICA TURCICA. 2023; 56(2): 170 - 179. 10.5505/aot.2023.41196
IEEE EROL C,HAFIZOĞLU E,aykan m,Guven D,Dursun B,Hizal M,kahraman s,sener dede d,Akinci M,Karadurmuş N,ÜRÜN Y,ALGIN E,yalcin s,yalcin b,Sendur M "Comparison of Adjuvant Modified FOLFIRINOX with Other Adjuvant Chemotherapies in Resected Pancreatic Adenocarcinoma: Real-life Data." ACTA ONCOLOGICA TURCICA, 56, ss.170 - 179, 2023. 10.5505/aot.2023.41196
ISNAD EROL, CİHAN vd. "Comparison of Adjuvant Modified FOLFIRINOX with Other Adjuvant Chemotherapies in Resected Pancreatic Adenocarcinoma: Real-life Data". ACTA ONCOLOGICA TURCICA 56/2 (2023), 170-179. https://doi.org/10.5505/aot.2023.41196