![rue mermoz besancon rue mermoz besancon](https://www.handzone.net/upload/actus/n1m/2009-2010/bazin_1_jpr.jpg)
More recently, two randomised phase III trials comparing gemcitabine with FOLFIRINOX and gemcitabine with gemcitabine plus nab-paclitaxel in first-line chemotherapy have shown a significant improvement in objective response rate (ORR), progression-free survival (PFS) and OS in patients with metastatic PC. No significant improvement in OS has been observed with any gemcitabine doublet, except for erlotinib, which provided a relatively low benefit. Since then, several randomised studies have been performed to improve the efficacy of first-line chemotherapy by combining gemcitabine with other cytotoxic or molecular targeted agents.
#Rue mermoz besancon trial#
Until recently, gemcitabine was considered as the standard therapy based on a randomised phase III trial showing a better clinical benefit and survival compared to 5-fluorouracil (5FU) chemotherapy. Palliative chemotherapy is most often the only treatment option for this group of patients. At the time of diagnosis, about half of patients have metastatic disease, with a very poor prognosis and a median overall survival (OS) of about 6 months. Pancreatic cancer (PC) accounts for approximately 2-3% of all malignant neoplasms worldwide, but is the fifth cause of cancer-related death in Western countries.
#Rue mermoz besancon Pc#
This study suggests that FOLFOX second-line therapy offered interesting efficacy results with an acceptable toxicity profile in metastatic PC patients with a good PS. For patients PS 0–1 versus 2–3, median PFS was 3.0 versus 1.2 months (log rank, p = 0.002), and median OS was 5.9 versus 2.6 months (log rank, p = 0.001). In multivariate analysis, PS was the only independent prognostic factor. Median PFS and OS were 1.7 and 4.3 months, respectively.
![rue mermoz besancon rue mermoz besancon](https://www.handzone.net/upload/actus/n1m/2009-2010/ahouari_m_3_jpr.jpg)
No objective response was observed, and disease control rate was 36%. At the end of follow-up, all patients had progressed and 25 had died. Grade 3 toxicity was observed in 33% of patients (no grade 4 toxicity). ResultsĪmong 46 patients who received second-line chemotherapy, 27 patients (male, 55% median age, 61 years performance status (PS) 0–1, 44%) were treated with FOLFOX after progression to first-line gemcitabine alone (n = 20) or FOLFIRI.3 alternating with gemcitabine (n = 7). Progression-free survival (PFS) and overall survival (OS) were estimated from the start of second-line chemotherapy using the Kaplan-Meier method. In this prospective observational cohort study, we analysed all consecutive patients who received second-line chemotherapy with FOLFOX among 98 patients with metastatic PC included in the FIRGEM study. The present study assessed the efficacy and safety of FOLFOX after failure of the first-line therapy used in the FIRGEM study. However, other therapeutics strategy has developed in first-line therapy, as the FIRGEM phase II study that evaluated gemcitabine alone versus FOLFIRI.3 alternating with gemcitabine every two months.
![rue mermoz besancon rue mermoz besancon](https://mermoz.anjou.e-lyco.fr/wp-content/uploads/sites/35/2020/06/IMG_13.jpg)
FOLFOX second-line treatment seems to be a validated option for patients with pancreatic cancer (PC) progressing after gemcitabine chemotherapy.