FOLFIRINOX Versus Gemcitabine/Nab-Paclitaxel for Neoadjuvant Treatment of Resectable and Borderline Resectable Pancreatic Head Adenocarcinoma

Background Both FOLFIRINOX and gemcitabine/nab-paclitaxel (G-nP) are used increasingly in the neoadjuvant treatment (NAT) of pancreatic ductal adenocarcinoma (PDA). This study aimed to compare neoadjuvant FOLFIRINOX and G-nP in the treatment of resectable (R) and borderline resectable (BR) head PDA....

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Bibliographic Details
Published in:Annals of surgical oncology 2018-07, Vol.25 (7), p.1896-1903
Main Authors: Dhir, Mashaal, Zenati, Mazen S., Hamad, Ahmad, Singhi, Aatur D., Bahary, Nathan, Hogg, Melissa E., Zeh, Herbert J., Zureikat, Amer H.
Format: Article
Language:English
Subjects:
Adenocarcinoma
Adenocarcinoma - drug therapy
Adenocarcinoma - pathology
Adenocarcinoma - surgery
Aged
Albumins - administration & dosage
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Camptothecin - administration & dosage
Cancer therapies
Carcinoma, Pancreatic Ductal - drug therapy
Carcinoma, Pancreatic Ductal - pathology
Carcinoma, Pancreatic Ductal - surgery
Chemotherapy
Comparative analysis
Computed tomography
Deoxycytidine - administration & dosage
Deoxycytidine - analogs & derivatives
Female
Fluorouracil - administration & dosage
Follow-Up Studies
Gemcitabine
Humans
Irinotecan - administration & dosage
Leucovorin - administration & dosage
Male
Medicine
Medicine & Public Health
Metastasis
Middle Aged
Neoadjuvant Therapy - mortality
Oncology
Paclitaxel
Paclitaxel - administration & dosage
Pancreas
Pancreatic cancer
Pancreatic Neoplasms - drug therapy
Pancreatic Neoplasms - pathology
Pancreatic Neoplasms - surgery
Pancreatic Tumors
Pancreaticoduodenectomy
Patients
Prognosis
Retrospective Studies
Surgery
Surgical Oncology
Survival
Survival Rate
Tumors
Citations: Items that this one cites
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Summary:Background Both FOLFIRINOX and gemcitabine/nab-paclitaxel (G-nP) are used increasingly in the neoadjuvant treatment (NAT) of pancreatic ductal adenocarcinoma (PDA). This study aimed to compare neoadjuvant FOLFIRINOX and G-nP in the treatment of resectable (R) and borderline resectable (BR) head PDA. Methods A single-institution retrospective review of R and BR patients undergoing pancreaticoduodenectomy after NAT with FOLFIRINOX or G-nP was performed. Comparative analysis was performed using inverse-probability-weighted (IPW) estimators. The end points of the study were overall survival (OS) and an 80% reduction in CA19-9 with NAT. Results In this study, 193 patients were analyzed, with 73 patients receiving FOLFIRINOX and 120 patients receiving G-nP. The median OS was 38.7 months for FOLFIRINOX versus 28.6 months for G-nP ( p  = 0.214). The patients who received FOLFIRINOX were younger and had fewer comorbidities, more BR disease, and larger tumors than those treated with G-nP (all p  
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-018-6512-8