A retrospective study of patient-tailored FOLFIRINOX as a first-line chemotherapy for patients with advanced biliary tract cancer
Abstract Background FOLFIRINOX is a pillar first-line regimen in the treatment of pancreatic cancer. Historically, biliary tract cancer (BTC) and pancreatic cancer have been treated similarly with gemcitabine alone or combined with a platinum compound. With growing evidence supporting the role of fl...
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| Format: | Article |
| Language: | English |
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BMC
2020-06-01
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| Series: | BMC Cancer |
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| Online Access: | http://link.springer.com/article/10.1186/s12885-020-07004-y |
| _version_ | 1828960936315060224 |
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| author | Ayhan Ulusakarya Abdoulaye Karaboué Oriana Ciacio Gabriella Pittau Mazen Haydar Pamela Biondani Yusuf Gumus Amale Chebib Wathek Almohamad Pasquale F. Innominato |
| author_facet | Ayhan Ulusakarya Abdoulaye Karaboué Oriana Ciacio Gabriella Pittau Mazen Haydar Pamela Biondani Yusuf Gumus Amale Chebib Wathek Almohamad Pasquale F. Innominato |
| author_sort | Ayhan Ulusakarya |
| collection | DOAJ |
| description | Abstract Background FOLFIRINOX is a pillar first-line regimen in the treatment of pancreatic cancer. Historically, biliary tract cancer (BTC) and pancreatic cancer have been treated similarly with gemcitabine alone or combined with a platinum compound. With growing evidence supporting the role of fluoropyrimidines in the treatment of BTC, we aimed at assessing the outcomes of patients (pts) with BTC on frontline FOLFIRINOX. Methods We retrospectively analyzed data of all our consecutive patients with locally advanced (LA) or metastatic (M) BTC who were registered to receive FOLFIRINOX as a first-line therapy between 12/2013 and 11/2017 at Paul Brousse university hospital. The main endpoints were Overall Survival (OS), Time-to-Progression (TTP), best Objective Response Rate (ORR), Disease Control rate (DCR), secondary macroscopically-complete resection (res) and incidence of severe (grade 3–4) toxicity (tox). Results There were 17 male (40%) and 25 female (60%) pts. aged 36 to 84 years (median: 67). They had PS of 0 (55%) or 1 (45%), and intrahepatic cholangiocarcinoma (CCA) (21 pts., 50%), gallbladder carcinoma (8 pts., 19%), perihilar CCA (7 pts., 17%), distal CCA (4 pts., 10%) and ampulloma (2 pts., 5%). BTC was LA or M in 10 (24%) and 32 pts. (76%) respectively. Biliary stent was placed in 14 pts. (33%). A median of 10 courses was given with median treatment duration of 6 months. There were no untoward toxicity issues, with no febrile neutropenia, emergency admission for toxicity or toxic death. We observed 12 partial responses (29%) and 19 disease stabilisations (45%). Six patients (14%) underwent secondary R0-R1 resection. Median TTP was 8 months [95%CL, 6–10] and median OS was 15 months [13–17]. Patients undergoing secondary resection displayed a 3-y disease-free rate of 83%. Conclusions First-line FOLFIRINOX offers promising results in patients with LA and M-BTC. It deserves prospective evaluation to further improve outcomes for advanced BTC. |
| first_indexed | 2024-12-14T09:36:26Z |
| format | Article |
| id | doaj.art-106f8d63d58d4dc79620a2fe6773c833 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-14T09:36:26Z |
| publishDate | 2020-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-106f8d63d58d4dc79620a2fe6773c8332022-12-21T23:07:55ZengBMCBMC Cancer1471-24072020-06-012011810.1186/s12885-020-07004-yA retrospective study of patient-tailored FOLFIRINOX as a first-line chemotherapy for patients with advanced biliary tract cancerAyhan Ulusakarya0Abdoulaye Karaboué1Oriana Ciacio2Gabriella Pittau3Mazen Haydar4Pamela Biondani5Yusuf Gumus6Amale Chebib7Wathek Almohamad8Pasquale F. Innominato9Assistance Publique-Hopitaux de Paris, Department of Medical Oncology, Paul Brousse HospitalINSERM U935 Campus CNRSAssistance Publique-Hôpitaux de Paris, Department of Surgery, Paul Brousse Hospital, Centre Hépato-BiliaireAssistance Publique-Hôpitaux de Paris, Department of Surgery, Paul Brousse Hospital, Centre Hépato-BiliaireAssistance Publique-Hopitaux de Paris, Department of Medical Oncology, Paul Brousse HospitalAssistance Publique-Hopitaux de Paris, Department of Medical Oncology, Paul Brousse HospitalAssistance Publique-Hopitaux de Paris, Department of Medical Oncology, Paul Brousse HospitalAssistance Publique-Hopitaux de Paris, Department of Medical Oncology, Paul Brousse HospitalAssistance Publique-Hopitaux de Paris, Department of Medical Oncology, Paul Brousse HospitalINSERM U935 Campus CNRSAbstract Background FOLFIRINOX is a pillar first-line regimen in the treatment of pancreatic cancer. Historically, biliary tract cancer (BTC) and pancreatic cancer have been treated similarly with gemcitabine alone or combined with a platinum compound. With growing evidence supporting the role of fluoropyrimidines in the treatment of BTC, we aimed at assessing the outcomes of patients (pts) with BTC on frontline FOLFIRINOX. Methods We retrospectively analyzed data of all our consecutive patients with locally advanced (LA) or metastatic (M) BTC who were registered to receive FOLFIRINOX as a first-line therapy between 12/2013 and 11/2017 at Paul Brousse university hospital. The main endpoints were Overall Survival (OS), Time-to-Progression (TTP), best Objective Response Rate (ORR), Disease Control rate (DCR), secondary macroscopically-complete resection (res) and incidence of severe (grade 3–4) toxicity (tox). Results There were 17 male (40%) and 25 female (60%) pts. aged 36 to 84 years (median: 67). They had PS of 0 (55%) or 1 (45%), and intrahepatic cholangiocarcinoma (CCA) (21 pts., 50%), gallbladder carcinoma (8 pts., 19%), perihilar CCA (7 pts., 17%), distal CCA (4 pts., 10%) and ampulloma (2 pts., 5%). BTC was LA or M in 10 (24%) and 32 pts. (76%) respectively. Biliary stent was placed in 14 pts. (33%). A median of 10 courses was given with median treatment duration of 6 months. There were no untoward toxicity issues, with no febrile neutropenia, emergency admission for toxicity or toxic death. We observed 12 partial responses (29%) and 19 disease stabilisations (45%). Six patients (14%) underwent secondary R0-R1 resection. Median TTP was 8 months [95%CL, 6–10] and median OS was 15 months [13–17]. Patients undergoing secondary resection displayed a 3-y disease-free rate of 83%. Conclusions First-line FOLFIRINOX offers promising results in patients with LA and M-BTC. It deserves prospective evaluation to further improve outcomes for advanced BTC.http://link.springer.com/article/10.1186/s12885-020-07004-yFOLFIRINOXAdvanced biliary tract cancerReal life practiceCholangiocarcinoma |
| spellingShingle | Ayhan Ulusakarya Abdoulaye Karaboué Oriana Ciacio Gabriella Pittau Mazen Haydar Pamela Biondani Yusuf Gumus Amale Chebib Wathek Almohamad Pasquale F. Innominato A retrospective study of patient-tailored FOLFIRINOX as a first-line chemotherapy for patients with advanced biliary tract cancer BMC Cancer FOLFIRINOX Advanced biliary tract cancer Real life practice Cholangiocarcinoma |
| title | A retrospective study of patient-tailored FOLFIRINOX as a first-line chemotherapy for patients with advanced biliary tract cancer |
| title_full | A retrospective study of patient-tailored FOLFIRINOX as a first-line chemotherapy for patients with advanced biliary tract cancer |
| title_fullStr | A retrospective study of patient-tailored FOLFIRINOX as a first-line chemotherapy for patients with advanced biliary tract cancer |
| title_full_unstemmed | A retrospective study of patient-tailored FOLFIRINOX as a first-line chemotherapy for patients with advanced biliary tract cancer |
| title_short | A retrospective study of patient-tailored FOLFIRINOX as a first-line chemotherapy for patients with advanced biliary tract cancer |
| title_sort | retrospective study of patient tailored folfirinox as a first line chemotherapy for patients with advanced biliary tract cancer |
| topic | FOLFIRINOX Advanced biliary tract cancer Real life practice Cholangiocarcinoma |
| url | http://link.springer.com/article/10.1186/s12885-020-07004-y |
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