Case analysis of pancreatic cancer treated with FOLFIRINOX in China

Shuang Si, Tina J. Hieken, Amy C. Degnim, Zhiying Yang, Haidong Tan, Yongliang Sun, Liguo Liu, Wenying Zhou, Jia Huang


Background: The FOLFIRINOX regimen recently became the new standard of care for patients with advanced pancreatic cancer. However, FOLFIRINOX hasn’t been widely used in China as the hesitance of oncologists to use FOLFIRINOX due to the toxicity of the regimen and the presumption that Chinese patients could not tolerate FOLFIRINOX.
Methods: We retrospectively analyzed the clinical data of ten patients with pancreatic cancer who received the FOLFIRINOX regimen from July 2016 to July 2018. The two woman and eight men enrolled were aged 29 to 76 years. Three, three, and four patients were diagnosed with borderline resectable pancreatic cancer (BRPC), liver-metastatic pancreatic cancer (LMPC), and recurrent pancreatic cancer (RPC), respectively. Seven and three patients received a full or 80% initial dose, according to their Eastern Cooperative Oncology Group performance status.
Results: One of the seven patients was administered an 80% dose after the second cycle because of febrile neutropenia (grade >3). The most common adverse event was neutropenia (grade 2). Four patients with BRPC or LMPC successfully underwent surgical resection. Two patients with LMPC achieved partial remission (PR). The levels of the serum carbohydrate antigen 19-9 of three patients with RPC significantly decreased (>60%).
Conclusions: The FOLFIRINOX regimen is effective and is tolerated by certain Chinese patients with advanced pancreatic cancer. The dose of the FOLFIRINOX regimen should be individually adjusted to reduce toxicity.