Sustained Disease Control with TOMOXIRI Regimen in a Patient with Metastatic Pancreatic Adenocarcinoma

Excerpt

Pancreatic adenocarcinoma (PAC) is one of the most aggressive cancers, and effective systemic treatment is crucial for the management of metastatic disease. Gemcitabine has been considered the standard of care since 1997 [1]. More recently, a randomized phase III trial involving 336 previously untreated metastatic PAC patients compared folinic acid, fluorouracil, irinotecan, oxaliplatin (FOLFIRINOX) regimen with gemcitabine [2]. Overall results revealed that the triplet was superior to gemcitabine in terms of overall survival (OS, 11.1 vs 6.8 months, HR = 0.57, p = .0001), progression-free survival (6.4 vs 3.3 months, p = .001), and response rate (RR, 31.6 vs 9.4 %, p = .0001), with the expense of excess toxicity in the experimental arm. Based on these findings, FOLFIRINOX is considered a reasonable option in first line in patients with good performance status and nearly normal bilirubin, besides emerging combinations such as the doublet gemcitabine and nab-paclitaxel [3]. …