Operated pancreatic cancer: New therapeutic standard
At the World Congress of Oncology (ASCO), held in June 2018 in Chicago, were presented data of the French study PRODIGE 24/CCTG PA.6 trial, which showed a significant advantage for patients operated for pancreatic ductal adenocarcinoma treated with polychemotherapy (modified FOLFIRINOX scheme), compared to those treated with gemcitabine monotherapy (therapeutic standard). Benefits both in terms of median time to recurrence (21.6 vs 12.8 months) and in terms of overall median survival (54.4 vs 35 months). Three years later, more than 15% of live patients were observed in the FOLFIRINOX treatment arm.
Very important data even if compared to the last adjuvant therapy trial (ESPAC-4), published by the English group (Neoptolemos JP, Lancet 2017), where the combination of gemcitabine and capecitabine had shown a statistically significant advantage but only in terms of overall median survival, compared to gemcitabine-based monotherapy (28 vs. 25.5 months).
New therapeutic standard in the treatment of pancreatic cancer
The FOLFIRINOX scheme therefore represents a new therapeutic standard in the treatment of pancreatic cancer. However, the profile of mostly hematological, gastroenterological and neurological toxicity, not negligible in a patient population often very weakened after a major surgery such as pancreatic, makes this treatment, a treatment addressed to that group of FIT patients, patients in good general conditions, in rapid post-surgical clinical recovery, mostly young and without severe co-morbidities.
Dr. Stefano Cereda
Specialized Oncologist in San Raffaele Hospital in Milano
Oncologist in the Division of Oncology at the San Raffaele Hospital in Milan. Dr. Stefano Cereda is specialized in the treatment of neoplastic diseases of the gastrointestinal tract (pancreatic cancer, gall bladder cancer, bile duct tumors, stomach and esophagus cancer). He performs clinical research activities focused on pancreatic cancer and bile duct tumors, such as gallbladder tumors, Vater papilla, intra-hepatic and extra-hepatic biliary tract cancer.