Modified-FOLFIRINOX in metastatic pancreatic cancer: A prospective study in Chinese population

FOLFIRINOX chemotherapy has shown remarkable responses in patients with metastatic pancreatic cancer (MPC), and has significantly improved prognosis. However, FOLFIRINOX is currently not frequently applied in China because of its high incidence of adverse events, and there is no recognized optimization for this therapy in Chinese population. Modification of FOLFIRINOX may be better for its acceptance in China. In this study, we evaluated the efficacy and safety of modified-FOLFIRINOX in patients with MPC. A total of 62 MPC patients were treated with modified-FOLFIRINOX (no Fluorouracil bolus, 85% Oxaliplatin and 75% Irinotecan) between April 2014 and April 2017 in our institute. 40 of them were evaluated, with a response rate of 32.5% (13/40). The frequent grade 3/4 adverse events are neutropenia (29%) and alanine aminotransferase elevation (14.5%). No treatment-related death was observed. The median overall survival and median progression-free survival are 10.3 months and 7.0 months, respectively. In conclusion, modified-FOLFIRINOX had significantly improved tolerance with similar efficacy to FOLFIRINOX. These findings may provide evidence for the use of FOLFIRINOX in Chinese patients with MPC. •This is the first prospective study to evaluate FOLFIRINOX in patients with metastatic pancreatic cancer from China.•The median overall survival and progression free survival time are extended to 10.3 m and 7.0 m respectively in 62 metastatic pancreatic cancer patients with modified-FOLFIRINOX regimens.•Our dose modification results in attenuated toxicity with an objective response rate of 32.5% and our plan is worthy to recommend to clinical use in China population.