Maintenance Therapy with FOLFIRI after FOLFIRINOX for Advanced Pancreatic Ductal Adenocarcinoma: A Retrospective Single-Center Analysis

OBJECTIVES: Patients with pancreatic ductal adenocarcinoma (PDA) receiving FOLFIRINOX often develop oxaliplatin-induced polyneuropathy, which limits the continuation of this therapy. We evaluated the efficacy and safety of FOLFIRI maintenance treatment after FOLFIRINOX induction in a retrospective single-center study. METHODS: Patients with advanced PDA treated with FOLFIRI as maintenance therapy after achieving disease control under FOLFIRINOX according to the local operating procedure between 2011 and 2016 were identified. Medical records of this group were evaluated retrospectively. RESULTS: Overall, 22 patients with PDA were treated with FOLFIRI (mean age 59 years, 55% female, 45% male). Before receiving FOLFIRI, all patients were treated with FOLFIRINOX for a median of 4 months. The median progression-free survival (PFS) under FOLFIRI maintenance therapy was 8 months. Side effects grade 3-4 (CTCAE v4.0) were observed in 18% of patients receiving FOLFIRI. Considering together FOLFIRINOX induction and subsequent FOLFIRI maintenance therapy, the median PFS was 11 months. The median overall survival (OS) from the beginning of palliative treatment was estimated at 46 months. CONCLUSIONS: In the selected group of PDA patients achieving disease control with FOLFIRINOX, FOLFIRI maintenance therapy was feasible, safe, and effective, with some patients achieving long-term disease stabilization.