Administration of FOLFIRINOX for Advanced Pancreatic Cancer: Physician Practice Patterns During Early Use
Advanced pancreatic cancer results in high morbidity and mortality. The standard of care treatment in the advanced setting changed in 2011 with the introduction of FOLFIRINOX (FFX) chemotherapy. However, it was highly toxic with significant risk of complications. We assessed the practice patterns of...
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MDPI AG
2025-02-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/32/3/128 |
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| author | Joanna Gotfrit Horia Marginean Yoo-Joung Ko Akmal Ghafoor Petr Kavan Haji Chalchal Shahid Ahmed Karen Mulder Patricia Tang Rachel Goodwin |
| author_facet | Joanna Gotfrit Horia Marginean Yoo-Joung Ko Akmal Ghafoor Petr Kavan Haji Chalchal Shahid Ahmed Karen Mulder Patricia Tang Rachel Goodwin |
| author_sort | Joanna Gotfrit |
| collection | DOAJ |
| description | Advanced pancreatic cancer results in high morbidity and mortality. The standard of care treatment in the advanced setting changed in 2011 with the introduction of FOLFIRINOX (FFX) chemotherapy. However, it was highly toxic with significant risk of complications. We assessed the practice patterns of medical oncologists across Canada. Methods: We performed a retrospective study of consecutive patients with advanced pancreatic cancer treated with FFX at eight Canadian cancer centers. Demographic, treatment, and outcome data were collected and analyzed. Results: The median age of the patients was 61 (range 24–80), 43% were female, 96% had an ECOG PS of 0 or 1, and 50% had three or more metastatic sites. The median follow-up time was 20.8 months (95%CI 18.6–24.9). Physicians started FFX at the standard dose 31% of the time. Physicians prescribed GCSF for primary prophylaxis most when giving standard-dose FFX (30% of the time) in comparison to reduced dose with or without the 5-FU bolus. Dose reductions occurred in 78.1% of patients, while dose delay occurred in 65.2% of patients. Conclusions: Medical oncologists in Canada historically prescribed FFX to patients with advanced pancreatic cancer in a fashion that was not uniform, prior to the emergence of evidence for upfront dose reductions. |
| format | Article |
| id | doaj-art-caa40af1de754346a4e8bcc5fc7f52ca |
| institution | OA Journals |
| issn | 1198-0052 1718-7729 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj-art-caa40af1de754346a4e8bcc5fc7f52ca2025-08-20T02:11:25ZengMDPI AGCurrent Oncology1198-00521718-77292025-02-0132312810.3390/curroncol32030128Administration of FOLFIRINOX for Advanced Pancreatic Cancer: Physician Practice Patterns During Early UseJoanna Gotfrit0Horia Marginean1Yoo-Joung Ko2Akmal Ghafoor3Petr Kavan4Haji Chalchal5Shahid Ahmed6Karen Mulder7Patricia Tang8Rachel Goodwin9The Ottawa Hospital Cancer Centre (TOHCC), Ottawa, ON K1H 8L6, CanadaThe Ottawa Hospital Cancer Centre (TOHCC), Ottawa, ON K1H 8L6, CanadaUnity Health, Toronto, ON M5B 1W8, CanadaWindsor Regional Hospital (WRH), Windsor, ON N8W 2X3, CanadaJewish General Hospital (JGH), Montréal, QC H3T 1E2, CanadaAllan Blair Cancer Centre (ABCC), Regina, SK S4T 7T1, CanadaSaskatoon Cancer Center (SCC), Saskatoon, SK S7N 4H4, CanadaCross Cancer Institute (CCI), Edmonton, AB T6G 1Z2, CanadaArthur J. E. Child Comprehensive Cancer Centre (ACCC), Calgary, AB T2N 5G2, CanadaThe Ottawa Hospital Cancer Centre (TOHCC), Ottawa, ON K1H 8L6, CanadaAdvanced pancreatic cancer results in high morbidity and mortality. The standard of care treatment in the advanced setting changed in 2011 with the introduction of FOLFIRINOX (FFX) chemotherapy. However, it was highly toxic with significant risk of complications. We assessed the practice patterns of medical oncologists across Canada. Methods: We performed a retrospective study of consecutive patients with advanced pancreatic cancer treated with FFX at eight Canadian cancer centers. Demographic, treatment, and outcome data were collected and analyzed. Results: The median age of the patients was 61 (range 24–80), 43% were female, 96% had an ECOG PS of 0 or 1, and 50% had three or more metastatic sites. The median follow-up time was 20.8 months (95%CI 18.6–24.9). Physicians started FFX at the standard dose 31% of the time. Physicians prescribed GCSF for primary prophylaxis most when giving standard-dose FFX (30% of the time) in comparison to reduced dose with or without the 5-FU bolus. Dose reductions occurred in 78.1% of patients, while dose delay occurred in 65.2% of patients. Conclusions: Medical oncologists in Canada historically prescribed FFX to patients with advanced pancreatic cancer in a fashion that was not uniform, prior to the emergence of evidence for upfront dose reductions.https://www.mdpi.com/1718-7729/32/3/128FOLFIRINOXadvanced pancreatic cancerclinical practicepractice patternsprescribing |
| spellingShingle | Joanna Gotfrit Horia Marginean Yoo-Joung Ko Akmal Ghafoor Petr Kavan Haji Chalchal Shahid Ahmed Karen Mulder Patricia Tang Rachel Goodwin Administration of FOLFIRINOX for Advanced Pancreatic Cancer: Physician Practice Patterns During Early Use Current Oncology FOLFIRINOX advanced pancreatic cancer clinical practice practice patterns prescribing |
| title | Administration of FOLFIRINOX for Advanced Pancreatic Cancer: Physician Practice Patterns During Early Use |
| title_full | Administration of FOLFIRINOX for Advanced Pancreatic Cancer: Physician Practice Patterns During Early Use |
| title_fullStr | Administration of FOLFIRINOX for Advanced Pancreatic Cancer: Physician Practice Patterns During Early Use |
| title_full_unstemmed | Administration of FOLFIRINOX for Advanced Pancreatic Cancer: Physician Practice Patterns During Early Use |
| title_short | Administration of FOLFIRINOX for Advanced Pancreatic Cancer: Physician Practice Patterns During Early Use |
| title_sort | administration of folfirinox for advanced pancreatic cancer physician practice patterns during early use |
| topic | FOLFIRINOX advanced pancreatic cancer clinical practice practice patterns prescribing |
| url | https://www.mdpi.com/1718-7729/32/3/128 |
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