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Clinico-biological factors predicting the benefit of the LV5FU2 maintenance strategy as a first-line therapy in patients with metastatic pancreatic cancer
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Clinico-biological factors predicting the benefit of the LV5FU2 maintenance strategy as a first-line therapy in patients with metastatic pancreatic cancer
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Journal Article
Clinico-biological factors predicting the benefit of the LV5FU2 maintenance strategy as a first-line therapy in patients with metastatic pancreatic cancer
2024
Overview
Abstract
Introduction
Predictive markers of LV5FU2 maintenance benefit after first-line induction with FOLFIRINOX in patients with metastatic pancreatic cancer are necessary to select patients who will not be harmed by this strategy.
Patients and Methods
We focused on patients who received 12 cycles of FOLFIRINOX (arm A, N = 88) or 8 cycles of FOLFIRINOX followed by LV5FU2 maintenance in controlled patients (arm B, N = 91) from the PRODIGE-35 trial. Prognostic factors and predictors of efficiency were identified by using Cox regression. Median progression-free survival (PFS), overall survival (OS), and time to deterioration of quality of life (TTD-QoL) were evaluated.
Results
Poor independent prognostic factors were primary tumor in place, age <65 years and the presence of liver metastases for PFS, a baseline neutrophil/lymphocyte ratio (NLR) ≥5 and CA19.9 ≥500 UI/L for OS, independent of the treatment arm. Patients with one metastatic site had a longer PFS in arm A, whereas patients with ≥2 metastatic sites had a longer PFS in arm B. We also identified predictors of OS and TTD-QoL in arm B but these differences were not statistically significant.
Conclusion
Except for patients with one metastatic site who benefited more from 12 cycles of FOLFIRINOX, a maintenance strategy with LV5FU2 should be widely offered to mPC patients whose survival and QoL are preserved after 4 months of FOLFIRINOX. (ClinicalTrials.gov: NCT02352337).
This retrospective analysis of the PRODIGE-35 trial showed that LV5FU2 maintenance after 8 cycles of FOLFIRINOX is feasible in patients treated first line for metastatic pancreatic cancer.
Publisher
Oxford University Press
Subject
/ Aged
/ Antineoplastic Combined Chemotherapy Protocols - therapeutic use
/ Cancer
/ Female
/ Fluorouracil - administration & dosage
/ Fluorouracil - therapeutic use
/ Humans
/ Irinotecan - administration & dosage
/ Irinotecan - therapeutic use
/ Leucovorin - administration & dosage
/ Leucovorin - therapeutic use
/ Male
/ Methods
/ Oxaliplatin - administration & dosage
/ Oxaliplatin - therapeutic use
/ Pancreatic Neoplasms - drug therapy
