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Combination chemotherapy improves survival in patients with pancreatic cancer - Video

Published On 2022-07-16T09:00:11+05:30  |  Updated On 16 July 2022 9:00 AM IST
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Overview

In a study of patients with borderline resectable pancreatic cancer, combination chemotherapy with modified FOLFIRINOX before surgery increased survival rate compared favorably to FOLFIRINOX plus hypofractionated radiotherapy. This is in accordance to recent research published in JAMA Oncology.

The multicenter, randomized Phase II Alliance clinical trial established presurgical, or neoadjuvant, FOLFIRINOX as the preferred therapy for these patients.

The objective of this study was to evaluate two neoadjuvant regimens for borderline resectable pancreatic cancer – one that uses FOLFIRINOX chemotherapy and one that uses systemic chemotherapy followed by stereotactic body radiation therapy (SBRT). The goal was to establish either or both treatments as standards of care.

The study included 126 patients treated at 50 sites, randomized to receive systemic therapy or systemic therapy and sequential hypofractionated radiotherapy.

Patients who met radiographic criteria were randomized to eight cycles of FOLFIRINOX chemotherapy or to seven cycles of FOLFIRINOX plus radiation therapy with SBRT or hypofractionated image-guided radiotherapy. Following restaging, patients suitable for surgery underwent pancreatectomy and then received four cycles of adjuvant folinic acid, fluorouracil and oxaliplatin (FOLFOX) chemotherapy.

Among patients who underwent pancreatectomy, complete resection with negative margins was achieved in 88% in the chemotherapy alone arm and 74% in the chemotherapy and radiation arm.

Given these study results, the authors hence believed that all patients with tumors described as borderline resectable should be treated with four months of FOLFIRINOX in anticipation of subsequent pancreatectomy.

Reference:

Katz MHG, Ou FS, Herman JM, Ahmad SA, Wolpin B, Marsh R, Behr S, Shi Q, Chuong M, Schwartz LH, Frankel W, Collisson E, Koay EJ, Hubbard JM, Leenstra JL, Meyerhardt J, O'Reilly E; Alliance for Clinical Trials on Oncology. Alliance for clinical trials in oncology (ALLIANCE) trial A021501: preoperative extended chemotherapy vs. chemotherapy plus hypofractionated radiation therapy for borderline resectable adenocarcinoma of the head of the pancreas. BMC Cancer. 2017 Jul 27;17(1):505. doi: 10.1186/s12885-017-3441-z.

Speakers

Dr. Nandita Mohan

Dr. Nandita Mohan is a practicing pediatric dentist with more than 5 years of clinical work experience. Along with this, she is equally interested in keeping herself up to date about the latest developments in the field of medicine and dentistry which is the driving force for her to be in association with Medical Dialogues. She also has her name attached with many publications; both national and international. She has pursued her BDS from Rajiv Gandhi University of Health Sciences, Bangalore and later went to enter her dream specialty (MDS) in the Department of Pedodontics and Preventive Dentistry from Pt. B.D. Sharma University of Health Sciences. Through all the years of experience, her core interest in learning something new has never stopped. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751
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