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The 2019 American guideline update that made six months of modified FOLFIRINOX the preferred chemotherapy after pancreatic cancer surgery for patients fit enough to take it, on the strength of a single trial.
ASCO convened an Expert Panel to evaluate PRODIGE 24/CCTG PA.6, the phase 3 trial of postoperative modified FOLFIRINOX versus gemcitabine presented at the 2018 ASCO Annual Meeting, and searched PubMed for other papers bearing on the existing recommendations. Only Recommendation 4.1 was updated: all patients with resected pancreatic adenocarcinoma who did not receive preoperative therapy should be offered six months of adjuvant chemotherapy in the absence of medical or surgical contraindications; modified FOLFIRINOX (oxaliplatin 85 mg/m2, leucovorin 400 mg/m2, irinotecan 150 mg/m2 day 1, fluorouracil 2.4 g/m2 over 46 hours every 14 days for 12 cycles) is preferred in the absence of concerns for toxicity or tolerance; gemcitabine plus capecitabine, gemcitabine alone or fluorouracil plus folinic acid alone can be offered instead.
The formal adoption of PRODIGE 24 into practice; every later debate about giving chemotherapy before rather than after surgery starts from this recommendation.
Shares Five-Year Outcomes of FOLFIRINOX vs Gemcitabine as Adjuvant Therapy for Pancreatic Cancer: A Randomized Clinical Trial, PRODIGE 24 / CCTG PA6, FOLFIRINOX / mFOLFIRINOX, Neoadjuvant / adjuvant / perioperative and the tag pancreatic-evidence.
Shares Five-Year Outcomes of FOLFIRINOX vs Gemcitabine as Adjuvant Therapy for Pancreatic Cancer: A Randomized Clinical Trial, FOLFIRINOX / mFOLFIRINOX, Neoadjuvant / adjuvant / perioperative, Resectable pancreatic ductal adenocarcinoma and the tag pancreatic-evidence.
Shares Neoadjuvant / adjuvant / perioperative, Resectable pancreatic ductal adenocarcinoma, Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question, Journal of Clinical Oncology and the tag pancreatic-evidence.
Shares Neoadjuvant / adjuvant / perioperative, Resectable pancreatic ductal adenocarcinoma, Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question, Pancreatic ductal adenocarcinoma and the tag pancreatic-evidence.
Shares Resectable pancreatic ductal adenocarcinoma, Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question, Gemcitabine, Pancreatic ductal adenocarcinoma and the tag pancreatic-evidence.
Shares Resectable pancreatic ductal adenocarcinoma, Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question, Pancreatic ductal adenocarcinoma and the tag pancreatic-evidence.
Shares Resectable pancreatic ductal adenocarcinoma, Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question, Pancreatic ductal adenocarcinoma and the tag pancreatic-evidence.
Shares PRODIGE 24 / CCTG PA6, Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question, Pancreatic ductal adenocarcinoma and the tag pancreatic-evidence.