Influence of initial dose intensity on efficacy of FOLFIRINOX in patients with advanced pancreatic cancer.

The combination of fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX) is the standard of care for advanced pancreatic cancer, but causes hematological and gastrointestinal toxicities, leading to treatment delay and dose reduction; optimal modification based on toxicities is needed. Therefore, we evaluated the effect of initial relative dose intensity (RDI) on FOLFIRINOX efficacy by conducting a Japanese nationwide survey. We evaluated overall survival (OS) and progression-free survival (PFS) of patients administered two or more cycles of FOLFIRINOX, and determined RDIs for each drug within the first two cycles. RDI's effect on efficacy was evaluated using a multivariate analysis with a Cox regression hazard model. Of 399 patients enrolled, 359 and 346 were evaluated for OS and PFS, respectively. Median RDI was 71.8%, 64.7%, 23.4%, and 76.9% for oxaliplatin, irinotecan, and bolus and continuous infusions of 5-FU, respectively. A high RDI for 5-FU bolus resulted in poor prognosis in terms of PFS (hazard ratio: 1.34;

Déclaration de conflit d'intérêts

CONFLICTS OF INTEREST S. Kobayashi: Honoraria from Yakult Honsha. N. Mizuno: Research funding from Zeria Pharmaceutical, Taiho Pharmaceutical Co. Ltd., Merck Serono, AstraZeneca, NanoCarrier, Eisai, and MSD; Honoraria from Yakult Honsha Co., Ltd, Taiho Pharmaceutical Co. Ltd., Novartis, Pfizer, and Kyowa-Hakko Kirin. H. Ueno: Honoraria from Yakult Honsha Co., Ltd Research Funding: Yakult Honsha Co., Ltd. A. Todaka: Honoraria from Yakult Honsha Co., Ltd, Daiichi Sankyo Co., Ltd. A. Fukutomi: Honoraria from Yakult Honsha Co., Ltd, Daiichi Sankyo Co., Ltd.; Advisory Role of Yakult Honsha Co., Ltd. All other authors have declared no conflicts of interest.