A prospective multicenter phase II study of FOLFIRINOX as a first-line treatment for patients with advanced and recurrent biliary tract cancer.


Journal

Investigational new drugs
ISSN: 1573-0646
Titre abrégé: Invest New Drugs
Pays: United States
ID NLM: 8309330

Informations de publication

Date de publication:
02 2023
Historique:
received: 17 09 2022
accepted: 22 11 2022
pubmed: 3 12 2022
medline: 24 3 2023
entrez: 2 12 2022
Statut: ppublish

Résumé

Given the promising activity and tolerability of FOLFIRINOX as a second-line treatment for advanced biliary tract cancer (BTC), it can be an attractive first-line treatment option as well. This is a single-arm, open-label, multicenter phase II study to evaluate the safety and efficacy of FOLFIRINOX as a first-line treatment for patients with advanced BTC. Primary endpoint was progression-free survival (PFS), and the secondary endpoints included overall survival (OS), tumor response and safety. This study defined primary endpoint might be met when the lower limit value of 80% confidence interval [CI] of the median PFS ≥ 6.0 months. Between June 2016 and March 2020, 35 BTC patients (21 intrahepatic, 10 extrahepatic, 2 gallbladder, 2 ampulla) including 26 unresectable and 9 recurrent disease were enrolled. After a median follow-up of 13.9 months, the median PFS and OS were 7.4 (80% CI, 5.5-7.5) and 14.7 (80% CI, 11.8-15.7) months, respectively. Complete response was achieved in 1 (2.9%) and partial response in 10 (28.6%), giving an objective response rate of 31.4% and disease control rate of 74.3%. Major grade 3-4 adverse events included neutropenia (54.3%), leukopenia (34.4%), febrile neutropenia (17.1%), thrombocytopenia (8.6%), cholangitis (8.6%), anemia, nausea, diarrhea, and peripheral sensory neuropathy (2.9% each). FOLFIRINOX was well tolerable in patients with advanced BTC, however, this study did not meet the primary endpoint to conduct a phase III trial. Thus, further explorations are required to find a subset of patients and/or certain clinical scenario which might be beneficial from FOLFIRINOX.

Identifiants

pubmed: 36459291
doi: 10.1007/s10637-022-01322-7
pii: 10.1007/s10637-022-01322-7
pmc: PMC9718456
doi:

Substances chimiques

folfirinox 0

Types de publication

Clinical Trial, Phase II Multicenter Study Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

76-85

Informations de copyright

© 2022. The Author(s).

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Auteurs

Naminatsu Takahara (N)

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

Yousuke Nakai (Y)

Department of Endoscopy and Endoscopic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. ynakai-tky@umin.ac.jp.

Hiroyuki Isayama (H)

Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo, Japan.

Takashi Sasaki (T)

Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.

Yuji Morine (Y)

Department of Surgery, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan.

Kazuo Watanabe (K)

Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Japan.

Makoto Ueno (M)

Department of Gastroenterology, Hepatobiliary and Pancreatic Medical Oncology Division, Kanagawa Cancer Center, Yokohama, Japan.

Tatsuya Ioka (T)

Oncology Center, Yamaguchi University Hospital, Ube, Japan.

Masashi Kanai (M)

Department of Therapeutic Oncology Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Shunsuke Kondo (S)

Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital Tokyo, Tokyo, Japan.

Naohiro Okano (N)

Department of Medical Oncology, Faculty of Medicine, Kyorin University, Tokyo, Japan.

Kazuhiko Koike (K)

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

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