5‐Fluorouracil/L‐Leucovorin Plus Oxaliplatin (FOLFOX) Regimen as Salvage Chemotherapy for Patients with Unresectable Pancreatic Cancer Receiving Gemcitabine and Nab‐Paclitaxel and 5‐Fluorouracil/L‐Leucovorin Plus Nanoliposomal Irinotecan: Preliminary Results from Clinical Practice

Abstract

Salvage chemotherapy for patients with unresectable pancreatic cancer (UR‐PC) who have been treated with gemcitabine and nab‐paclitaxel (GnP), and 5‐fluorouracil (5‐FU)/l‐leucovorin (LV) plus nanoliposomal irinotecan (nal‐IRI), has not been fully established. We retrospectively reviewed data from 17 patients with UR‐PC who initiated 5‐FU/l‐LV plus oxaliplatin (FOLFOX) as salvage chemotherapy at our hospital between June 2020 and August 2021, after treatment with GnP and 5‐ FU/LV plus nal‐IRI. The primary endpoint was tumor response. The secondary endpoints were pro-gression‐free survival (PFS) and adverse events (AEs). The response and disease control rates were 5.9% (1/17) and 17.6% (3/17), respectively. The median PFS was 1.8 months (range: 0.4–5.2 months). Eight patients (47.1%) experienced grade 3 nonhematologic AEs, while none experienced grade 3 hematologic AEs. Two patients with controlled disease had homologous recombination deficiency (HRD)‐associated gene mutations in cancer panel testing. The FOLFOX regimen benefit for UR‐PC patients treated with GnP and 5‐FU/LV plus nal‐IRI may be limited to patients with HRD‐associated gene mutations.