Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Chemotherapy. 2013;59(4):273-9. doi: 10.1159/000356158. Epub 2014 Jan 18.
BACKGROUND/AIMS: There is no standard consensus on a strategy in the second-line setting for gemcitabine-refractory advanced pancreatic cancer. This study evaluated the activity and tolerability of oxaliplatin, irinotecan, 5-fluorouracil and leucovorin (FOLFIRINOX) as a second-line therapy in advanced pancreatic adenocarcinoma pretreated with a gemcitabine-based regimen.
A retrospective survey was carried out on 18 patients with advanced pancreatic cancer who had been on gemcitabine-based chemotherapy and were then treated with FOLFIRINOX as a second-line therapy.
One patient (5.6%) had a confirmed complete response, 4 (22.2%) had confirmed partial responses and 5 (27.8%) had stable disease, resulting in a rate of disease control of 55.6% (95% CI, 33.3-77.8%). The median progression-free survival and median survival were 2.8 months and 8.4 months, respectively. Seven patients (38.9%) experienced grade 3-4 neutropenia. Grade 3 or 4 nonhematologic adverse events included nausea (38.9%) and vomiting (16.7%).
These results suggest the modest clinical activity regarding efficacy and the acceptable toxicity profile with the FOLFIRINOX regimen as a second-line treatment.
背景/目的：对于吉西他滨耐药的晚期胰腺癌，二线治疗方案尚无标准共识。本研究评估了奥沙利铂、伊立替康、5-氟尿嘧啶和亚叶酸（FOLFIRINOX）在吉西他滨为基础的方案预处理后的晚期胰腺腺癌的二线治疗中的活性和耐受性。
对 18 例接受过吉西他滨为基础的化疗且随后接受 FOLFIRINOX 二线治疗的晚期胰腺癌患者进行了回顾性调查。
1 例患者（5.6%）有确认的完全缓解，4 例患者（22.2%）有确认的部分缓解，5 例患者（27.8%）有稳定的疾病，疾病控制率为 55.6%（95%可信区间，33.3-77.8%）。无进展生存期和总生存期的中位数分别为 2.8 个月和 8.4 个月。7 例患者（38.9%）发生 3-4 级中性粒细胞减少。3 级或 4 级非血液学不良事件包括恶心（38.9%）和呕吐（16.7%）。
这些结果表明，FOLFIRINOX 方案作为二线治疗具有一定的疗效和可接受的毒性特征。
