Efectiveness and safety with new treatments in pancreatic cancer

In recent years, the regimes of chemotherapy based on the administration of Oxaliplatin, Irinotecan, Fluorouracil and Leucovorin (FOLFIRINOX) and Nab-Paclitaxel/Gemcitabine have become therapies of choice in pancreatic cancer (PC). Objective: To compare the effectiveness and safety of FOLFIRINOX vs Nab- Paclitaxel/Gemcitabine in patients with PC. Method: Retrospective comparative study of a treatment for adult patients with PC who received FOLFIRINOX and/or Nab-Paclitaxel/Gemcitabine. Effectiveness outcomes were evaluated in terms of progression free survival (PFS) and overall survival (OS). Safety outcomes were evaluated according to the adverse events (AE) profile from the CTCAE criteria v 4.0. Results: We analyzed 68 patients, 28 treated with FOLFIRINOX, 40 treated with Nab-Paclitaxel/Gemcitabine. Effectiveness (FOLFIRINOX vs NabP/GZT): PFS (RIC) in first line was 7.13 months (4.23-12.97) vs. 5.43 months (1.7-9.73). HR for disease progression was 6.98 (p = 0.163). OS (RIC) in first line was 11.4 months (5.9-12.6) vs 9.2 months (4.2-12.2) HR for death was 1.95 (p = 0.414). Safety: 73.52% of patients presented some AE (78% FOLFIRINOX vs 70% NabP/GZT). Grade >3 were more frequent in the FOLFIRINOX group. Conclusions: Patients treated with FOLFIRINOX presented a major PFS and OS. Regarding the safety profile, AE were more frequent and more severe with FOLFIRINOX. As main clinical practice guidelines, we consider FOLFIRINOX to be a standard treatment option for patients with advanced disease and good performance status