{"entity":{"id":"paper-prodige-24-five-year-outcomes-jama-oncol-2022","kind":"paper","name":"Five-Year Outcomes of FOLFIRINOX vs Gemcitabine as Adjuvant Therapy for Pancreatic Cancer: A Randomized Clinical Trial","aka":[],"tldr":"The 2022 five-year report of PRODIGE 24 confirming that modified FOLFIRINOX after pancreatic cancer surgery gives a median survival of about four and a half years against three with gemcitabine, and that 43 percent of patients were alive at five years.","summary":"The mature analysis of the PRODIGE 24/Canadian Cancer Trials Group PA6 trial, 493 patients aged 18 to 79 randomised at 77 hospitals in France and Canada between April 2012 and October 2016 within 3 to 12 weeks of R0 or R1 resection to 24 weeks of modified FOLFIRINOX or gemcitabine; data cutoff June 2021, median follow-up 69.7 months. Median disease-free survival was 21.4 versus 12.8 months (hazard ratio 0.66) and five-year disease-free survival 26.1 versus 19.0 percent; median overall survival was 53.5 versus 35.5 months (hazard ratio 0.68, 95 percent confidence interval 0.54 to 0.85, P = 0.001) and five-year overall survival 43.2 versus 31.4 percent; median metastasis-free survival 29.4 versus 17.7 months (hazard ratio 0.64) and cancer-specific survival 54.7 versus 36.3 months (hazard ratio 0.65). Multivariable analysis identified modified FOLFIRINOX, age, tumour grade, staging and larger-volume centre as favourable prognostic factors.","asOf":"2026-09-24","links":[{"label":"JAMA Oncol 2022","url":"https://doi.org/10.1001/jamaoncol.2022.3829"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/36048453/"},{"label":"ClinicalTrials.gov NCT01526135","url":"https://clinicaltrials.gov/study/NCT01526135"}],"tags":["pancreatic-evidence"],"related":["paper-prodige-24-adjuvant-mfolfirinox-pancreatic-nejm-2018","paper-asco-potentially-curable-pancreatic-guideline-update-jco-2019"],"cancers":["pancreatic","resectable-pdac"],"sections":[],"technologies":["cytotoxic-chemotherapy"],"targets":[],"drugs":["folfirinox","gemcitabine"],"companies":["unicancer"],"institutions":[],"pathways":[],"terms":["os","hazard-ratio","neoadjuvant-adjuvant"],"trials":["prodige-24","nct07252232","nct05968326"],"people":["thierry-conroy"],"bottlenecks":[],"keyPapers":[],"journals":["jama-oncology"],"dependsOn":[],"notes":[],"journal":"JAMA Oncology","year":2022,"doi":"10.1001/jamaoncol.2022.3829","pmid":"36048453","authors":"Conroy T, Castan F, Lopez A, et al.","paperType":"rct","findings":["493 patients; median follow-up 69.7 months.","Median overall survival 53.5 versus 35.5 months (hazard ratio 0.68); five-year overall survival 43.2 versus 31.4 percent.","Median disease-free survival 21.4 versus 12.8 months (hazard ratio 0.66); metastasis-free survival 29.4 versus 17.7 months.","Larger-volume centre was an independent favourable prognostic factor."],"whatItMeans":"The best survival ever recorded in a pancreatic cancer trial, and the benchmark every perioperative trial (PREOPANC-3, Alliance A021806) and every adjuvant RAS inhibitor or vaccine trial (RASolute 304, IMCODE003) now has to beat or add to.","caveats":["Fit patients under 80 who had recovered from surgery within 12 weeks; a minority of all diagnosed patients.","The centre-volume finding is observational within the trial but supports centralisation of pancreatic surgery."],"changedPractice":true,"participants":493},"route":"/key-papers/paper-prodige-24-five-year-outcomes-jama-oncol-2022/","neighbours":{"paper":[{"id":"paper-preopanc-2-neoadjuvant-folfirinox-vs-chemoradiotherapy-lancet-oncol-2025","kind":"paper","name":"Neoadjuvant FOLFIRINOX versus neoadjuvant gemcitabine-based chemoradiotherapy in resectable and borderline resectable pancreatic cancer (PREOPANC-2): a multicentre, open-label, phase 3 randomised trial","route":"/key-papers/paper-preopanc-2-neoadjuvant-folfirinox-vs-chemoradiotherapy-lancet-oncol-2025/"},{"id":"paper-asco-potentially-curable-pancreatic-guideline-update-jco-2019","kind":"paper","name":"Potentially Curable Pancreatic Adenocarcinoma: ASCO Clinical Practice Guideline Update","route":"/key-papers/paper-asco-potentially-curable-pancreatic-guideline-update-jco-2019/"},{"id":"paper-prodige-24-adjuvant-mfolfirinox-pancreatic-nejm-2018","kind":"paper","name":"PRODIGE 24/CCTG PA6: adjuvant modified FOLFIRINOX versus gemcitabine after resection of pancreatic cancer","route":"/key-papers/paper-prodige-24-adjuvant-mfolfirinox-pancreatic-nejm-2018/"}],"cancer":[{"id":"pancreatic","kind":"cancer","name":"Pancreatic ductal adenocarcinoma","route":"/cancers/pancreatic/"},{"id":"resectable-pdac","kind":"cancer","name":"Resectable pancreatic ductal adenocarcinoma","route":"/cancers/resectable-pdac/"}],"technology":[{"id":"cytotoxic-chemotherapy","kind":"technology","name":"Cytotoxic chemotherapy","route":"/technologies/cytotoxic-chemotherapy/"}],"drug":[{"id":"folfirinox","kind":"drug","name":"FOLFIRINOX / mFOLFIRINOX","route":"/drugs/folfirinox/"},{"id":"gemcitabine","kind":"drug","name":"Gemcitabine","route":"/drugs/gemcitabine/"}],"company":[{"id":"unicancer","kind":"company","name":"UNICANCER","route":"/companies/unicancer/"}],"term":[{"id":"hazard-ratio","kind":"term","name":"Hazard ratio (HR)","route":"/terms/hazard-ratio/"},{"id":"neoadjuvant-adjuvant","kind":"term","name":"Neoadjuvant / adjuvant / perioperative","route":"/terms/neoadjuvant-adjuvant/"},{"id":"os","kind":"term","name":"Overall survival (OS)","route":"/terms/os/"}],"trial":[{"id":"nct05968326","kind":"trial","name":"A Study of the Efficacy and Safety of Adjuvant Autogene Cevumeran Plus Atezolizumab and mFOLFIRINOX Versus mFOLFIRINOX Alone in Participants With Resected PDAC","route":"/trials/nct05968326/"},{"id":"prodige-24","kind":"trial","name":"PRODIGE 24 / CCTG PA6","route":"/trials/prodige-24/"},{"id":"nct07252232","kind":"trial","name":"Study of Daraxonrasib (RMC-6236) in Patients With Resected Pancreatic Ductal Adenocarcinoma (PDAC)","route":"/trials/nct07252232/"}],"person":[{"id":"thierry-conroy","kind":"person","name":"Thierry Conroy","route":"/people/thierry-conroy/"}],"journal":[{"id":"jama-oncology","kind":"journal","name":"JAMA Oncology","route":"/journals/jama-oncology/"}],"roadmap":[{"id":"pancreatic-roadmap","kind":"roadmap","name":"Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question","route":"/roadmaps/pancreatic-roadmap/"}],"idea":[{"id":"idea-pdac-neoadjuvant-chemotherapy-for-all-resectable-disease","kind":"idea","name":"Chemotherapy before surgery for every resectable pancreatic cancer, settled by the two perioperative trials rather than assumed","route":"/ideas/idea-pdac-neoadjuvant-chemotherapy-for-all-resectable-disease/"}]}}