Neoadjuvant‐modified FOLFIRINOX vs nab‐paclitaxel plus gemcitabine for borderline resectable or locally advanced pancreatic cancer patients who achieved surgical resection
Abstract We conducted an institutional study to compare the clinical and pathological efficacy between the neoadjuvant therapy (NAT)‐modified FOLFIRINOX (mFOLF) vs nanoparticle albumin–bound paclitaxel plus gemcitabine (nab‐P/G) for borderline resectable pancreatic cancer (BRPC) and locally advanced...
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| Language: | English |
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Wiley
2020-07-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.3075 |
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| author | Adam R. Wolfe Dhivya Prabhakar Vedat O. Yildiz Jordan M. Cloyd Mary Dillhoff Laith Abushahin Dayssy Alexandra Diaz Eric D. Miller Wei Chen Wendy L. Frankel Anne Noonan Terence M. Williams |
| author_facet | Adam R. Wolfe Dhivya Prabhakar Vedat O. Yildiz Jordan M. Cloyd Mary Dillhoff Laith Abushahin Dayssy Alexandra Diaz Eric D. Miller Wei Chen Wendy L. Frankel Anne Noonan Terence M. Williams |
| author_sort | Adam R. Wolfe |
| collection | DOAJ |
| description | Abstract We conducted an institutional study to compare the clinical and pathological efficacy between the neoadjuvant therapy (NAT)‐modified FOLFIRINOX (mFOLF) vs nanoparticle albumin–bound paclitaxel plus gemcitabine (nab‐P/G) for borderline resectable pancreatic cancer (BRPC) and locally advanced pancreatic cancer (LAPC) patients who completed resection. The study retrospectively enrolled patients with pathologically confirmed BRPC or LAPC from 2010 to 2018 at our institution. The survival rates were determined by the Kaplan‐Meier method and log‐rank test was used to test differences. Cox's proportional hazard model was used to assess survival with respect to covariates. Seventy‐two patients who completed at least two cycles of neoadjuvant chemotherapy and surgical resection were included, with 52 (72.2%) patients receiving mFOLF and 20 (27.8%) receiving nab‐P/G. Patients treated with mFOLF had statistically higher rates of RECIST 1.1 partial or complete response (16/52 vs 1/20, P = .028). Additionally, mFOLF patients had greater pathological tumor size reduction, fewer positive lymph nodes, and higher treatment response grade compared to the nab‐P/G patients (all P < .05). The median overall survival was 33.3 months vs 27.1 months (P = .105), and distant metastasis‒free survival (DMFS) was 21.3 months vs 14.6 months (P = .042) in the mFOLF vs nab‐P/G groups, respectively. On multivariate analysis, mFOLF (hazard ratio, 0.428; 95% confidence interval [CI], 0.186‐0.987) and abnormal postoperative CA 19‐9 (hazard ratio, 2.47; 95% CI, 1.06‐5.76) were associated with DMFS. Among patients with BRPC and LAPC who complete surgical resection, neoadjuvant mFOLF was associated with improved pathological and clinical outcomes compared with nab‐P/G. |
| format | Article |
| id | doaj-art-3ba0bea06cf741efb65f72e32a2d27d5 |
| institution | DOAJ |
| issn | 2045-7634 |
| language | English |
| publishDate | 2020-07-01 |
| publisher | Wiley |
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| series | Cancer Medicine |
| spelling | doaj-art-3ba0bea06cf741efb65f72e32a2d27d52025-08-20T02:40:11ZengWileyCancer Medicine2045-76342020-07-019134711472310.1002/cam4.3075Neoadjuvant‐modified FOLFIRINOX vs nab‐paclitaxel plus gemcitabine for borderline resectable or locally advanced pancreatic cancer patients who achieved surgical resectionAdam R. Wolfe0Dhivya Prabhakar1Vedat O. Yildiz2Jordan M. Cloyd3Mary Dillhoff4Laith Abushahin5Dayssy Alexandra Diaz6Eric D. Miller7Wei Chen8Wendy L. Frankel9Anne Noonan10Terence M. Williams11Department of Radiation Oncology Ohio State University James Comprehensive Cancer Center Columbus OH USADepartment of Medical Oncology Ohio State University James Comprehensive Cancer Center Columbus OH USADepartment of Biomedical Informatics Ohio State College of Medicine Columbus OH USADepartment of Surgical Oncology Ohio State University James Comprehensive Cancer Center Columbus OH USADepartment of Surgical Oncology Ohio State University James Comprehensive Cancer Center Columbus OH USADepartment of Medical Oncology Ohio State University James Comprehensive Cancer Center Columbus OH USADepartment of Radiation Oncology Ohio State University James Comprehensive Cancer Center Columbus OH USADepartment of Radiation Oncology Ohio State University James Comprehensive Cancer Center Columbus OH USADepartment of Pathology Ohio State University James Comprehensive Cancer Center Columbus OH USADepartment of Pathology Ohio State University James Comprehensive Cancer Center Columbus OH USADepartment of Medical Oncology Ohio State University James Comprehensive Cancer Center Columbus OH USADepartment of Radiation Oncology Ohio State University James Comprehensive Cancer Center Columbus OH USAAbstract We conducted an institutional study to compare the clinical and pathological efficacy between the neoadjuvant therapy (NAT)‐modified FOLFIRINOX (mFOLF) vs nanoparticle albumin–bound paclitaxel plus gemcitabine (nab‐P/G) for borderline resectable pancreatic cancer (BRPC) and locally advanced pancreatic cancer (LAPC) patients who completed resection. The study retrospectively enrolled patients with pathologically confirmed BRPC or LAPC from 2010 to 2018 at our institution. The survival rates were determined by the Kaplan‐Meier method and log‐rank test was used to test differences. Cox's proportional hazard model was used to assess survival with respect to covariates. Seventy‐two patients who completed at least two cycles of neoadjuvant chemotherapy and surgical resection were included, with 52 (72.2%) patients receiving mFOLF and 20 (27.8%) receiving nab‐P/G. Patients treated with mFOLF had statistically higher rates of RECIST 1.1 partial or complete response (16/52 vs 1/20, P = .028). Additionally, mFOLF patients had greater pathological tumor size reduction, fewer positive lymph nodes, and higher treatment response grade compared to the nab‐P/G patients (all P < .05). The median overall survival was 33.3 months vs 27.1 months (P = .105), and distant metastasis‒free survival (DMFS) was 21.3 months vs 14.6 months (P = .042) in the mFOLF vs nab‐P/G groups, respectively. On multivariate analysis, mFOLF (hazard ratio, 0.428; 95% confidence interval [CI], 0.186‐0.987) and abnormal postoperative CA 19‐9 (hazard ratio, 2.47; 95% CI, 1.06‐5.76) were associated with DMFS. Among patients with BRPC and LAPC who complete surgical resection, neoadjuvant mFOLF was associated with improved pathological and clinical outcomes compared with nab‐P/G.https://doi.org/10.1002/cam4.3075chemotherapyFOLFIRINOXnab‐paclitaxelneoadjuvantpancreatic cancerradiation |
| spellingShingle | Adam R. Wolfe Dhivya Prabhakar Vedat O. Yildiz Jordan M. Cloyd Mary Dillhoff Laith Abushahin Dayssy Alexandra Diaz Eric D. Miller Wei Chen Wendy L. Frankel Anne Noonan Terence M. Williams Neoadjuvant‐modified FOLFIRINOX vs nab‐paclitaxel plus gemcitabine for borderline resectable or locally advanced pancreatic cancer patients who achieved surgical resection Cancer Medicine chemotherapy FOLFIRINOX nab‐paclitaxel neoadjuvant pancreatic cancer radiation |
| title | Neoadjuvant‐modified FOLFIRINOX vs nab‐paclitaxel plus gemcitabine for borderline resectable or locally advanced pancreatic cancer patients who achieved surgical resection |
| title_full | Neoadjuvant‐modified FOLFIRINOX vs nab‐paclitaxel plus gemcitabine for borderline resectable or locally advanced pancreatic cancer patients who achieved surgical resection |
| title_fullStr | Neoadjuvant‐modified FOLFIRINOX vs nab‐paclitaxel plus gemcitabine for borderline resectable or locally advanced pancreatic cancer patients who achieved surgical resection |
| title_full_unstemmed | Neoadjuvant‐modified FOLFIRINOX vs nab‐paclitaxel plus gemcitabine for borderline resectable or locally advanced pancreatic cancer patients who achieved surgical resection |
| title_short | Neoadjuvant‐modified FOLFIRINOX vs nab‐paclitaxel plus gemcitabine for borderline resectable or locally advanced pancreatic cancer patients who achieved surgical resection |
| title_sort | neoadjuvant modified folfirinox vs nab paclitaxel plus gemcitabine for borderline resectable or locally advanced pancreatic cancer patients who achieved surgical resection |
| topic | chemotherapy FOLFIRINOX nab‐paclitaxel neoadjuvant pancreatic cancer radiation |
| url | https://doi.org/10.1002/cam4.3075 |
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