A single institution retrospective review of efficacy, toxicity, and symptom burden in patients (pts) with pancreatic cancer (PaC) receiving FOLFIRINOX chemotherapy.

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e15221 Background: PaC is associated with a poor prognosis. FOLFIRINOX chemotherapy improves overall survival (OS) in this disease, but may be associated with poor tolerance, and toxicity. We sought to evaluate efficacy, toxicity and symptom burden in a consecutive series of PaC pts receiving FOLFIRINOX. Methods: All pts at CancerCare Manitoba who had received ≥1 cycle of FOLFIRINOX for unresectable & metastatic PaC in the 1st line setting between February 2009 and February 2013 were identified. A retrospective health record review was undertaken to collect clinical information. Kaplan-Meier survival curves were created. Edmonton Symptom Assessment Scale (ESAS) scores were collected on available patients before, during and after treatment (tx). ESAS scores were compared using a quantile mixed regression model to detect median differences between groups. Results: We identified 37 pts, median age of 60 (36-76), of whom 24 (64.9%) were male. At presentation, 27 (73%) had metastatic disease. Primary tumor location included head 21 (56.8%), tail 9 (24.3%), body 5 (13.5%), and neck 2 (5.4%). A range of 1 to 47+ FOLFIRNOX cycles were administered (mean 14.2 and median 8). Blood work parameters were the most common reason for tx modification in 22 (59.5%) pts, with patient tolerance modifying tx in 10 (27%) pts. Oxaliplatin was removed for 13 (35.1%) pts due to neurotoxicity. Median OS was 12.0 months (36.7 – 71.1), with no difference in OS based on gender (p=0.972), tumor location (p=0.747) or extent of disease (i.e. metastatic versus locally advanced) (p=0.280). ESAS scores improved (indicating fewer symptoms) for pain (p=0.031), tiredness (p=0.046), nausea (p=0.034), drowsiness (p=0.01), appetite (p=0.003) and shortness of breath (p=0.027) in pts receiving FOLFIRINOX compared to those not receiving chemotherapy . Conclusions: At our institution FOLFIRINOX use demonstrated OS comparable to recent trials. The lower ESAS scores for pain, tiredness, nausea, drowsiness, appetite and shortness of breath in pts receiving FOLFIRINOX supports it as a tolerable tx. Whether the degree of ESAS score change is clinically significant is unknown and merits further study.

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