title: [Modified FOLFIRINOX for advanced pancreatic cancer: a tertiary center experience from China].
abstract: OBJECTIVE
  To explore efficacy and safety of modified FOLFIRINOX (mFOLFIRINOX) regimen by dose attenuation in locally advanced pancreatic cancer (LAPC) and metastatic pancreatic cancer(MPC).
  
  
  METHODS
  Between April 2014 and October 2015, 35 patients with LAPC (n=18) or MPC (n=17) were treated with mFOLFIRINOX regimen (irinotecan 135 mg/m(2), oxaliplatin 68 mg/m(2), 5-FU 2 400 mg/m(2), no bolus of 5-FU, leucovorin 400 mg/m(2)) in the Second Affiliated Hospital of Zhejiang University School of Medicine. The primary end point was progression free survival. The second end points were overall survival, objective response rate, adverse effects, surgical resection rate for LAPC.
  
  
  RESULTS
  Among 35 patients, 6 patients (17.1%) who dropped out and received less than 2 cycles were excluded for response analysis. Among the other 29 patients, 9 patients had grade 3 or 4 adverse effects. No patients ceased treatment due to adverse effects. The 29 patients received 5 (2-13) cycles were evaluated by efficacy and found partial remission in 16 cases, stable disease in 10 cases, progression disease in 3 cases. Response rate was 55.2%. Nine patients with LAPC accomplished surgery after neoadjuvant treatment without perioperative complication and death, and 6 patients accepted R0 resection.
  
  
  CONCLUSIONS
  The mFOLFIRINOX regimen used in the study is well-tolerated in Chinese population with high treatment efficacy on patients with LAPC and MPC. Further investigation of efficacy and adverse effects on more advanced pancreatic cancer patients is necessary.
authors.affiliation: Department of Hepatopancreatobiliary Surgery, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China.
authors.forename: Xueli
authors.initials: X
authors.lastname: Bai
authors.forename: Riga
authors.initials: R
authors.lastname: Su
authors.forename: Tao
authors.initials: T
authors.lastname: Ma
authors.forename: Shichao
authors.initials: S
authors.lastname: Shen
authors.forename: Guogang
authors.initials: G
authors.lastname: Li
authors.forename: Jianying
authors.initials: J
authors.lastname: Lou
authors.forename: Shunliang
authors.initials: S
authors.lastname: Gao
authors.forename: Risheng
authors.initials: R
authors.lastname: Que
authors.forename: Ying
authors.initials: Y
authors.lastname: Yuan
authors.forename: Risheng
authors.initials: R
authors.lastname: Yu
authors.forename: Qichun
authors.initials: Q
authors.lastname: Wei
authors.forename: Tingbo
authors.initials: T
authors.lastname: Liang
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D018450:Disease Progression; D018572:Disease-Free Survival; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D000077146:Irinotecan; D002955:Leucovorin / Q000008:administration & dosage; D020360:Neoadjuvant Therapy; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D010190:Pancreatic Neoplasms / Q000188:drug therapy*; D062606:Tertiary Care Centers; D016896:Treatment Outcome
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D000077146:Irinotecan; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin