Treatment Response and Conditional Survival in Advanced Pancreatic Cancer Patients Treated with FOLFIRINOX: A Multicenter Cohort Study

Fleur van der Sijde; Jacob L van Dam; Bas Groot Koerkamp; Brigitte C M Haberkorn; Marjolein Y V Homs; Daniëlle Mathijssen; Marc G Besselink; Johanna W Wilmink; Casper H J van Eijck

doi:10.1155/2022/8549487

Treatment Response and Conditional Survival in Advanced Pancreatic Cancer Patients Treated with FOLFIRINOX: A Multicenter Cohort Study

J Oncol. 2022 Jul 7:2022:8549487. doi: 10.1155/2022/8549487. eCollection 2022.

Authors

Fleur van der Sijde¹, Jacob L van Dam¹, Bas Groot Koerkamp¹, Brigitte C M Haberkorn², Marjolein Y V Homs³, Daniëlle Mathijssen⁴, Marc G Besselink⁵, Johanna W Wilmink⁶, Casper H J van Eijck¹

Affiliations

¹ Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.
² Department of Medical Oncology, Maasstad Hospital, Rotterdam, Netherlands.
³ Department of Medical Oncology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.
⁴ Department of Medical Oncology, Franciscus Gasthuis, Rotterdam, Netherlands.
⁵ Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.
⁶ Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.

Abstract

Background: FOLFIRINOX chemotherapy is the current Dutch standard of care for locally advanced (LAPC) and metastatic pancreatic cancer (PDAC) patients with good performance status. The objective of this study was to evaluate real-world response rates and survival in advanced PDAC and to assess conditional survival after FOLFIRINOX.

Methods: A multicenter, retrospective cohort study was conducted in four hospitals in the Netherlands. Consecutive patients with LAPC or metastatic PDAC, treated with FOLFIRINOX, were included.

Results: Between 2012 and 2018, 284 patients were included: n = 136 with LAPC and n = 148 with metastatic PDAC. Objective response rates were similar in both the groups: 14.0% in LAPC and 18.2% in metastatic patients. The disease control rate was higher in LAPC patients (77.2%) compared to metastatic PDAC (51.4%, P < 0.001). Median overall survival (OS) in LAPC patients was 12.7 months (95% CI 11.4-14.1 months). Their 2-year survival probability increased from 14% to 26% one year after the completion of FOLFIRINOX. Median OS in metastatic PDAC patients was 8.1 months (95% CI 6.5-9.6 months); 2-year survival probability increased from 10% to 29% after one year. Discussion. Our study provides real-world estimates of response rates, survival, and conditional survival in patients with advanced PDAC treated with FOLFIRINOX. These results are useful for patient counseling and clinical decision making.