- After neoadjuvant FOLFIRINOX treatment, adjuvant chemotherapy is associated with benefit only in patients with node-positive disease.
- Adjuvant FOLFIRINOX and gemcitabine chemotherapy were associated with survival benefit.
Why this matters
- This is the first large study of patients receiving adjuvant chemotherapy after neoadjuvant FOLFIRINOX.
- International cohort study (N=520).
- Funding: European-African Hepato-Pancreato-Biliary Association.
- 66.0% of patients received adjuvant chemotherapy: 19.8% FOLFIRINOX, 58.6% gemcitabine-based chemotherapy, 4.1% capecitabine, 13.1% a combination or other agents, 4.4% unknown.
- Median of 6 cycles of FOLFIRINOX (folinic acid, fluorouracil, irinotecan, and oxaliplatin).
- Median follow-up, 35 months.
- Overall median OS, 38 months after diagnosis and 31 months after surgery.
- There was no significant difference in median OS between patients who received adjuvant chemotherapy and those who did not (HR, 0.99; P=.93).
- Subgroup analyses showed an association between survival and adjuvant chemotherapy in pathology-proven node-positive disease (HR, 0.41; P=.004), but not in node-negative disease (HR, 0.85; P=.73).
- By type of adjuvant therapy, improved survival was associated with gemcitabine (27 vs 13 months; 95% CI, 9-20) and FOLFIRINOX (28 vs 13 months; 95% CI, 23 to not reached).
- Retrospective design.