First-line FOLFIRINOX (leucovorin, fluorouracil, irinotecan, oxaliplatin) is associated with median overall survival of approximately 2 years in patients with locally advanced pancreatic cancer, according to a systematic review and patient-level meta-analysis reported by Suker et al.1
The patient-level meta-analysis included 315 patients from 11 studies reporting survival outcomes. Median overall survival from the start of FOLFIRINOX ranged from 10.0 months to 32.7 months across studies, with a pooled patient-level median overall survival of 24.2 months (95% confidence interval [CI] = 21.7–26.8 months). Median progression-free survival ranged from 3.0 to 20.4 months, with a patient-level median progression-free survival of 15.0 months (95% CI = 13.8–16.2 months).
The proportions of patients who underwent radiotherapy or chemoradiotherapy ranged from 31% to 100% across studies, the proportion who underwent resection ranged from 0% to 43%, and the proportion of those with R0 resection ranged from 50% to 100%.
The investigators concluded:
Patients with locally advanced pancreatic cancer treated with FOLFIRINOX had a median overall survival of 24.2 months—longer than that reported with gemcitabine (6–13 months). Future research should assess these promising results in a randomised controlled trial and should establish which patients might benefit from radiotherapy or chemoradiotherapy or resection after FOLFIRINOX.