Modified FOLFIRINOX in pancreatic cancer patients Age 75 or older

Jonathan D. Mizrahi, Jane E. Rogers, Kenneth R. Hess, Robert A. Wolff, Gauri R. Varadhachary, Milind M. Javle, Rachna T. Shroff, Linus Ho, David R. Fogelman, Kanwal P.S. Raghav, Michael J. Overman, Shubham Pant

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

Background: Although FOLFIRINOX (5-Fluorouracil + leucovorin + irinotecan + oxaliplatin) is now the standard of care for patients (pts) with metastatic pancreatic cancer (PC) based on the 2011 study by Conroy et al. which demonstrated improved median overall survival (mOS), pts > 75 yrs old were excluded from this study. The purpose of this study was to assess the safety and efficacy of modified FOLFIRINOX (mFOLFIRINOX) in this population. Methods: We retrospectively analyzed unresectable PC pts, age ≥ 75, treated with mFOLFIRINOX at MD Anderson from 2011 to 2017. Primary outcome was rate of grade 3 or 4 hematologic toxicity (HT). Results: 24 pts were included. Grade 3 or 4 HT occurred in 11 pts 6 pts required hospitalization for any toxicity, and 10 stopped mFOLFIRINOX due to toxicity. The most frequently used starting doses of infusional 5-FU, irinotecan and oxaliplatin were 2400, 150 and 75 mg/m2, respectively. Median PFS was 3.7 months (95% CI: 3.0–5.7) with a median OS of 11.6 months (95% CI: 6.14–15.7). For first line pts, median PFS and OS were 5.1 (95% CI: 2.0–12.8) and 12.2 months (95% CI: 4.8–30.8), respectively. Conclusions: In this single-center retrospective analysis of unresectable PC pts age 75 or older given mFOLFIRINOX, toxicities and survival outcomes were similar to those reported in the initial study. These data indicate that the use of modified dosing FOLFIRINOX in advanced PC pts older than 75 appears to maintain similar toxicity and efficacy when compared to younger pts.

Original languageEnglish (US)
Pages (from-to)501-504
Number of pages4
JournalPancreatology
Volume20
Issue number3
DOIs
StatePublished - Apr 2020

Keywords

  • Chemotherapy
  • Elderly
  • FOLFIRINOX
  • Geriatric oncology
  • Retrospective studies
  • Safety

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Gastroenterology

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