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Evaluation of gemcitabine efficacy after the FOLFIRINOX regimen in patients with advanced pancreatic adenocarcinoma.

Abstract To evaluate gemcitabine efficacy in advanced pancreatic cancer patients after the FOLFIRINOX regimen.Patients with locally-advanced or metastatic pancreatic adenocarcinoma from French and Canadian centers, who were treated with the first-line FOLFIRINOX regimen (FFX L1), followed by gemcitabine monotherapy as a second-line treatment (GEM L2), were retrospectively evaluated. Statistical analyses were performed on the demographic, toxicity, and response rate data. Overall survival (OS) and progression-free survival (PFS) were assessed using the Kaplan-Meier method.Seventy-two patients were reviewed (median age of 63.5 years [range, 32-75 years], men [62%], predominantly pancreatic head tumor location [51%] and metastatic disease [64%] at the time of diagnosis). The objective response rate to GEM-L2 treatment was 8/72 (11%), and 32 patients (44%) experienced a clinical benefit from gemcitabine. Four patients had a partial response to GEM-L2, although they previously showed a progressive response following FFX-L1 treatment. The median OS for the entire cohort was 13.6 months (95% confidence interval [CI]: 2.0-35). The median PFS of the GEM-L2 group was 2.5 months (95% CI: 0.2-10.8) with no statistical differences between patients with controlled or progressive disease on FFX-L1 therapy.Gemcitabine as a second-line treatment for advanced pancreatic adenocarcinoma after FOLFIRINOX failure showed clinical benefits in some patients.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 28422841
OWN - NLM
STAT- MEDLINE
DA  - 20170419
DCOM- 20170509
LR  - 20170509
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 16
DP  - 2017 Apr
TI  - Evaluation of gemcitabine efficacy after the FOLFIRINOX regimen in patients with 
      advanced pancreatic adenocarcinoma.
PG  - e6544
LID - 10.1097/MD.0000000000006544 [doi]
AB  - To evaluate gemcitabine efficacy in advanced pancreatic cancer patients after the
      FOLFIRINOX regimen.Patients with locally-advanced or metastatic pancreatic
      adenocarcinoma from French and Canadian centers, who were treated with the
      first-line FOLFIRINOX regimen (FFX L1), followed by gemcitabine monotherapy as a 
      second-line treatment (GEM L2), were retrospectively evaluated. Statistical
      analyses were performed on the demographic, toxicity, and response rate data.
      Overall survival (OS) and progression-free survival (PFS) were assessed using the
      Kaplan-Meier method.Seventy-two patients were reviewed (median age of 63.5 years 
      [range, 32-75 years], men [62%], predominantly pancreatic head tumor location
      [51%] and metastatic disease [64%] at the time of diagnosis). The objective
      response rate to GEM-L2 treatment was 8/72 (11%), and 32 patients (44%)
      experienced a clinical benefit from gemcitabine. Four patients had a partial
      response to GEM-L2, although they previously showed a progressive response
      following FFX-L1 treatment. The median OS for the entire cohort was 13.6 months
      (95% confidence interval [CI]: 2.0-35). The median PFS of the GEM-L2 group was
      2.5 months (95% CI: 0.2-10.8) with no statistical differences between patients
      with controlled or progressive disease on FFX-L1 therapy.Gemcitabine as a
      second-line treatment for advanced pancreatic adenocarcinoma after FOLFIRINOX
      failure showed clinical benefits in some patients.
FAU - Gilabert, Marine
AU  - Gilabert M
AD  - aDepartment of Medical Oncology, Paoli-Calmettes Institute, Marseille, France
      bDepartment of Medical Oncology, Jewish General Hospital, McGill University,
      Montreal, QC , Canada cDepartment of Gastroenterology dDepartment of Digestive
      Surgery, Paoli-Calmettes Institute, Marseille, France.
FAU - Chanez, Brice
AU  - Chanez B
FAU - Rho, Young Soo
AU  - Rho YS
FAU - Giovanini, Marc
AU  - Giovanini M
FAU - Turrini, Olivier
AU  - Turrini O
FAU - Batist, Gerald
AU  - Batist G
FAU - Kavan, Petr
AU  - Kavan P
FAU - Raoul, Jean Luc
AU  - Raoul JL
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Organoplatinum Compounds)
RN  - 0W860991D6 (Deoxycytidine)
RN  - B76N6SBZ8R (gemcitabine)
RN  - Q573I9DVLP (Leucovorin)
RN  - U3P01618RT (Fluorouracil)
RN  - Folfox protocol
RN  - Pancreatic Carcinoma
SB  - AIM
SB  - IM
MH  - Adult
MH  - Aged
MH  - Antineoplastic Combined Chemotherapy Protocols/administration &
      dosage/*therapeutic use
MH  - Canada
MH  - Deoxycytidine/administration & dosage/*analogs & derivatives/therapeutic use
MH  - Disease-Free Survival
MH  - Female
MH  - Fluorouracil/administration & dosage/therapeutic use
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Leucovorin/administration & dosage/therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Organoplatinum Compounds/administration & dosage/therapeutic use
MH  - Pancreatic Neoplasms/*drug therapy/pathology
MH  - Retrospective Studies
PMC - PMC5406057
EDAT- 2017/04/20 06:00
MHDA- 2017/05/10 06:00
CRDT- 2017/04/20 06:00
AID - 10.1097/MD.0000000000006544 [doi]
AID - 00005792-201704210-00022 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Apr;96(16):e6544. doi: 10.1097/MD.0000000000006544.

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