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Clinical Trial
. 2018 Dec 20;379(25):2395-2406.
doi: 10.1056/NEJMoa1809775.

"VSports" FOLFIRINOX or Gemcitabine as Adjuvant Therapy for Pancreatic Cancer

Thierry Conroy  1 , Pascal Hammel  1 , Mohamed Hebbar  1 , Meher Ben Abdelghani  1 , Alice C Wei  1 , Jean-Luc Raoul  1 , Laurence Choné  1 , Eric Francois  1 , Pascal Artru  1 , James J Biagi  1 , Thierry Lecomte  1 , Eric Assenat  1 , Roger Faroux  1 , Marc Ychou  1 , Julien Volet  1 , Alain Sauvanet  1 , Gilles Breysacher  1 , Frédéric Di Fiore  1 , Christine Cripps  1 , Petr Kavan  1 , Patrick Texereau  1 , Karine Bouhier-Leporrier  1 , Faiza Khemissa-Akouz  1 , Jean-Louis Legoux  1 , Béata Juzyna  1 , Sophie Gourgou  1 , Christopher J O'Callaghan  1 , Claire Jouffroy-Zeller  1 , Patrick Rat  1 , David Malka  1 , Florence Castan  1 , Jean-Baptiste Bachet  1 ; Canadian Cancer Trials Group and the Unicancer-GI–PRODIGE Group
Collaborators, Affiliations
Clinical Trial

FOLFIRINOX or Gemcitabine as Adjuvant Therapy for Pancreatic Cancer

"VSports手机版" Thierry Conroy et al. N Engl J Med. .

Abstract

Background: Among patients with metastatic pancreatic cancer, combination chemotherapy with fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX) leads to longer overall survival than gemcitabine therapy VSports手机版. We compared the efficacy and safety of a modified FOLFIRINOX regimen with gemcitabine as adjuvant therapy in patients with resected pancreatic cancer. .

Methods: We randomly assigned 493 patients with resected pancreatic ductal adenocarcinoma to receive a modified FOLFIRINOX regimen (oxaliplatin [85 mg per square meter of body-surface area], irinotecan [180 mg per square meter, reduced to 150 mg per square meter after a protocol-specified safety analysis], leucovorin [400 mg per square meter], and fluorouracil [2400 mg per square meter] every 2 weeks) or gemcitabine (1000 mg per square meter on days 1, 8, and 15 every 4 weeks) for 24 weeks. The primary end point was disease-free survival. Secondary end points included overall survival and safety. V体育安卓版.

Results: At a median follow-up of 33. 6 months, the median disease-free survival was 21. 6 months in the modified-FOLFIRINOX group and 12. 8 months in the gemcitabine group (stratified hazard ratio for cancer-related event, second cancer, or death, 0. 58; 95% confidence interval [CI], 0. 46 to 0. 73; P<0. 001) V体育ios版. The disease-free survival rate at 3 years was 39. 7% in the modified-FOLFIRINOX group and 21. 4% in the gemcitabine group. The median overall survival was 54. 4 months in the modified-FOLFIRINOX group and 35. 0 months in the gemcitabine group (stratified hazard ratio for death, 0. 64; 95% CI, 0. 48 to 0. 86; P=0. 003). The overall survival rate at 3 years was 63. 4% in the modified-FOLFIRINOX group and 48. 6% in the gemcitabine group. Adverse events of grade 3 or 4 occurred in 75. 9% of the patients in the modified-FOLFIRINOX group and in 52. 9% of those in the gemcitabine group. One patient in the gemcitabine group died from toxic effects (interstitial pneumonitis). .

Conclusions: Adjuvant therapy with a modified FOLFIRINOX regimen led to significantly longer survival than gemcitabine among patients with resected pancreatic cancer, at the expense of a higher incidence of toxic effects. (Funded by R&D Unicancer and others; ClinicalTrials VSports最新版本. gov number, NCT01526135 ; EudraCT number, 2011-002026-52 . ). .

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