Can Platinum Plus Gemcitabine be an Alternative to Folfirinox?
Serkan Yildirim1, Cengiz Yilmaz2, Ahmet Ozveren31Department of Medical Oncology, Baskent University Konya Hospital, Konya, Türkiye, 2Department of Medical Oncology, Izmir Bozyaka Training and Research Hospital, Izmir, Türkiye, 3Department of Medical Oncology, Private Izmir Kent Hospital, Izmir, Türkiye
Objectives: In cases where homologous recombination repair (HRR) gene analysis is performed, platinum-based chemotherapy is better than other chemotherapy regimens. FOLFIRINOX is the regimen of choice for first-line treatment of pancreatic cancer. However, it is a toxic regimen, and not all patients can tolerate this treatment. Because HRR genes are frequently detected in pancreatic cancer and because FOLFIRINOX treatment cannot be applied to every patient, platinum-based therapies can be used as a first-line therapy. For this reason, we conducted this study to show the firstline effect of a platinum-gemcitabine combination for the treatment of metastatic pancreatic cancer. Methods: This retrospective and multicenter study included patients admitted to five centers in Turkey between 2010 and 2017. The inclusion criteria were as follows: patients older than 18, diagnosed with metastatic pancreatic cancer, with no previous local treatment (surgery or radiotherapy), with no chemotherapy for metastatic disease, and with an ECOG performance score of 0–2. Results: A total of 217 patients were included in the study. Of these, 103 were administered gemcitabine alone, and 114 were administered gemcitabine plus cisplatin/carboplatin. Overall survival was significantly longer in the gemcitabine-cisplatin/carboplatin group than in the gemcitabine alone group (9.8 months vs. 5.2 months; p<0.001). Likewise, progression-free survival was statistically significantly longer in the gemcitabine-cisplatin/carboplatin group than in the gemcitabine alone group (4.9 months vs. 3.2 months; p<0.001). Conclusion: In cases where HRR gene analysis cannot be performed during the treatment of patients with metastatic pancreatic cancer, a patient who cannot tolerate FOLFIRINOX can be treated with a combination of cisplatin/carboplatin-gemcitabine as a first-line treatment. However, larger prospective studies are needed to confirm its effectiveness. Keywords: Cisplatin, FOLFIRINOX, first line, pancreatic cancer
Cite This Article
Yildirim S, Yilmaz C, Ozveren A. Can Platinum Plus Gemcitabine be an Alternative to Folfirinox?. EJMI. 2023; 7(3): 246-250
Corresponding Author: Serkan Yildirim