[A Pancreatic Cancer Patient in Whom Pegfilgrastim Prophylaxis Did Not Prevent Severe Neutropenia Caused by the FOLFIRINOX Regimen].

Recently, newer agents in regimens such as FOLFIRINOX have shown promising activity, being superior to gemcitabine as a single agent for unresectable pancreatic cancer patients with good performance status. Herein, we report a case of pancreatic cancer treated with the FOLFIRINOX regimen and pegfilgrastim prophylaxis as second-line treatment in a patient who failed this regimen. He previously received gemcitabine/nab-paclitaxel combination chemotherapy as first-line treatment. It was reported that grade 3-4 neutropenia frequently occurred in many patients receiving the FOLFIRINOX regimen. Prophylactic use of pegfilgrastim is recommended for cancer patients who are at high risk of neutropenic events. However, severe neutropenia occurred with the FOLFIRINOX regimen in spite of pegfilgrastim prophylaxis. We emphasize the importance of occasional serious adverse effects with the FOLFIRINOX regimen and pegfilgrastim prophylaxis.