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Giving FOLFIRINOX before surgery did not help people with clearly resectable pancreatic head cancer: fewer were alive at 18 months than those who went straight to surgery.
Nordic multicentre randomised phase 2 trial: 140 patients with resectable pancreatic head cancer were assigned to four cycles of neoadjuvant FOLFIRINOX then surgery and adjuvant chemotherapy (77) or upfront surgery and adjuvant chemotherapy (63). The primary endpoint was survival at 18 months by intention to treat.
60 percent of the neoadjuvant group were alive at 18 months against 73 percent of the upfront surgery group (p 0.032); median overall survival was 25.1 against 38.5 months (hazard ratio 1.52). Resection rates were 82 and 89 percent; grade 3 or worse adverse events occurred in 58 and 40 percent.
Upfront surgery followed by adjuvant chemotherapy remains standard for clearly resectable pancreatic cancer; neoadjuvant treatment belongs in trials or borderline disease.
Shares Chemotherapy before surgery for every resectable pancreatic cancer, settled by the two perioperative trials rather than assumed, FOLFIRINOX / mFOLFIRINOX, Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question, Pancreatic ductal adenocarcinoma.
Shares Neoadjuvant FOLFIRINOX versus neoadjuvant gemcitabine-based chemoradiotherapy in resectable and borderline resectable pancreatic cancer (PREOPANC-2): a multicentre, open-label, phase 3 randomised trial, Resectable pancreatic ductal adenocarcinoma, Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question, Pancreatic ductal adenocarcinoma.
Shares NORPACT-1, FOLFIRINOX / mFOLFIRINOX, Resectable pancreatic ductal adenocarcinoma, Pancreatic ductal adenocarcinoma.
Shares Neoadjuvant FOLFIRINOX versus neoadjuvant gemcitabine-based chemoradiotherapy in resectable and borderline resectable pancreatic cancer (PREOPANC-2): a multicentre, open-label, phase 3 randomised trial, Chemotherapy before surgery for every resectable pancreatic cancer, settled by the two perioperative trials rather than assumed, FOLFIRINOX / mFOLFIRINOX, Resectable pancreatic ductal adenocarcinoma.
Shares NORPACT-1, Neoadjuvant FOLFIRINOX versus neoadjuvant gemcitabine-based chemoradiotherapy in resectable and borderline resectable pancreatic cancer (PREOPANC-2): a multicentre, open-label, phase 3 randomised trial, Chemotherapy before surgery for every resectable pancreatic cancer, settled by the two perioperative trials rather than assumed, Resectable pancreatic ductal adenocarcinoma.
Shares NORPACT-1, Resectable pancreatic ductal adenocarcinoma, Pancreatic ductal adenocarcinoma.
Shares NORPACT-1, FOLFIRINOX / mFOLFIRINOX, Resectable pancreatic ductal adenocarcinoma, Pancreatic ductal adenocarcinoma.
Shares Neoadjuvant FOLFIRINOX versus neoadjuvant gemcitabine-based chemoradiotherapy in resectable and borderline resectable pancreatic cancer (PREOPANC-2): a multicentre, open-label, phase 3 randomised trial, Chemotherapy before surgery for every resectable pancreatic cancer, settled by the two perioperative trials rather than assumed, Resectable pancreatic ductal adenocarcinoma, Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question.