Cancer Therapy AdvisorNeoadjuvant FOLFIRINOX Does Not Improve OS in Resectable Pancreatic Cancer

Neoadjuvant Chemotherapy and Upfront Surgery: A Comparative Study in Resectable Pancreatic Cancer

In a recent study presented at the 2023 ASCO Annual Meeting, researchers found no significant survival benefit of neoadjuvant chemotherapy over upfront surgery in patients with resectable pancreatic cancer.

Key Points:

• The phase 2 trial involved 140 patients with resectable pancreatic cancer from Norway, Sweden, Denmark, and Finland.
• Patients were randomly assigned to receive either neoadjuvant fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX) followed by surgery and adjuvant modified FOLFIRINOX or upfront surgery and adjuvant modified FOLFIRINOX.
• The median overall survival (OS) was 25.1 months in the neoadjuvant FOLFIRINOX arm and 38.5 months in the upfront surgery arm.
• The proportion of patients alive at 18 months was 60% in the neoadjuvant arm and 73% in the upfront surgery arm.
• In the per-protocol population, the R0 resection rate was 59% in the neoadjuvant arm and 33% in the upfront surgery arm.
• The rate of grade 3-5 adverse events was higher among patients who received neoadjuvant FOLFIRINOX compared to those who received adjuvant chemotherapy.
• Common grade 3-5 adverse events among patients who received neoadjuvant chemotherapy were diarrhea, nausea and vomiting, and neutropenia.