Abstract
Introduction: Pancreatic cancer represents ~2% of all cancers (6% of all cancer deaths). The therapeutic results at all stages of the disease are worse than those of other solid tumours.
Methods: Analysis was conducted of 47 patients treated for advanced pancreatic cancer between January 2013 and July 2016 at the Department of Oncology of the First Faculty of Medicine and General University Hospital in Prague. Patients were treated with a modified FOLFIRINOX regimen with 75% reduction (oxaliplatine 85 mg/sqm, irinotecane 180 mg/sqm, leucovorine 400 mg/sqm, bolus of 5-fluorouracile 400 mg/sqm, and continual infusion of 5-fluorouracile 2,400 mg/sqm for 46 hours every two weeks) without primary prophylaxis with hematopoietic growth factors as the first line of therapy.
The antitumour efficacy (number of objective responses, time to progression, and overall survival) and adverse events were monitored. Results: The median time to progression was 6.5 months (10.1 months in patients with locally advanced disease; n = 18).
The best observed response was complete remission in two cases and partial admission in 13 cases according to RECIST. Operability was achieved in four (22.2%) of 18 patients with locally advanced pancreatic cancer.
The median overall survival was 17.6 months from diagnosis of inoperable locally advanced or generalized tumours. Conclusion: In patients with advanced pancreatic cancer and a good performance status (0-1), FOLFIRINOX may significantly prolong time to progression and overall survival with good quality of life.