Neoadjuvant mFOLFIRINOX Studied for Borderline Resectable PDAC

WEDNESDAY, Aug. 3, 2022 (HealthDay News) -- For patients with borderline resectable pancreatic ductal adenocarcinoma (PDAC), favorable overall survival was observed following treatment with eight cycles of neoadjuvant modified FOLFIRINOX (mFOLFIRINOX), according to a study published online July 14 in JAMA Oncology.

Matthew H.G. Katz, M.D., from the University of Texas MD Anderson Cancer Center in Houston, and colleagues conducted a randomized phase 2 clinical trial from February 2017 to January 2019 involving 126 patients with borderline resectable PDAC. Participants were registered to systemic therapy (eight treatment cycles of mFOLFIRINOX) and to systemic therapy and sequential radiotherapy (seven cycles of mFOLFIRINOX followed by stereotactic body radiotherapy or hypofractionated image-guided radiotherapy; 55.6 and 44.4 percent, respectively, in arms 1 and 2).

The researchers found that among the first 30 evaluable patients enrolled to each arm, 17 and 10 in arms 1 and 2, respectively, had undergone margin-negative resection, resulting in closure of arm 2 and full enrollment in arm 1. Of the evaluable patients, the 18-month overall survival rate was 66.7 and 47.3 percent in arms 1 and 2, respectively. The median overall survival of evaluable patients was 29.8 and 17.1 months in arms 1 and 2, respectively.

"Eight cycles of treatment with mFOLFIRINOX was established as a reference neoadjuvant regimen for patients with borderline resectable PDAC," the authors write.

Several authors disclosed financial ties to the biopharmaceutical industry.

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