FOLFIRINOX versus Gemcitabine for Metastatic Pancreatic Cancer

Abstract

As compared with gemcitabine, FOLFIRINOX was associated with a survival advantage and had increased toxicity. FOLFIRINOX is an option for the treatment of patients with metastatic pancreatic cancer and good performance status. (Funded by the French government and others; ClinicalTrials.gov number, NCT00112658.).

Augmentation of response to nab-paclitaxel by inhibition of insulin-like growth factor (IGF) signaling in preclinical pancreatic cancer models

“…Gemcitabine, a nucleoside analog, has limited clinical benefits but it remained a standard treatment for locally advanced and metastatic PDAC since 1997 after producing a response rate of 5% and a median survival of 5.7 months [8]. FOLFIRINOX, a combination of chemotherapy agents (oxaliplatin, irinotecan, 5-FU/leucovorin), nearly doubled the median survival of PDAC patients (11.1 months compared with 6.8 months in the gemcitabine group), but this regimen is highly toxic with serious side effects [9]. Nab-paclitaxel (NPT), a water-soluble albumin-bound paclitaxel, has recently shown efficacy against advanced PDAC [10, 11], and nab-paclitaxel in combination with gemcitabine demonstrated 8.5 months median survival compared with 6.7 months after gemcitabine alone [12].…”

Human pancreatic cancer progression: an anarchy among CCN-siblings

“…Currently, there are a few FDA-approved efficacious therapies for chemo-resistant patients that help improve survival for 4-11 months compared to the old standard of care (gemcitabine therapy) (Conroy et al 2011;Han and Von Hoff 2013;Von Hoff et al 2013;Von Hoff et al 2009;Wang-Gillam et al 2016). Thereby, chemoresistance is still a challenging task for PC therapy.…”

“…The median overall survival (OS) in these therapeutic groups remains modest, varying from 4 to 12 months with degradation of quality of life (Conroy et al 2011;Mohammed et al 2015;Von Hoff et al 2013;WangGillam et al 2016). The limited efficacies of these drugs are due to the acquisition of chemo-resistant characteristics of PDAC.…”

Phase 2 placebo-controlled, double-blind trial of dasatinib added to gemcitabine for patients with locally-advanced pancreatic cancer

“…Gemcitabine remains one therapeutic option for patients with advanced PDAC and provides a marginal survival advantage [1,2]. Among other therapeutic options, two combination regimens have further extended survival prolongation of gemcitabine [3,4].…”