FOLFIRINOX Compared to Gemcitabine Plus Nab-Paclitaxel For Pancreatic Cancer
According to results from a real-world study, FOLFIRINOX significantly improved survival compared to gemcitabine plus nab-paclitaxel among patients with borderline resectable pancreatic cancer, but came with higher toxicity.
“FOLFIRINOX and gemcitabine plus nab-paclitaxel are standard treatments with differing toxicity profiles and outcomes,” stated Arif Mohammed Khan, Asian Institute of Gastroenterology, Hyderabad, India, and coauthors. “This study evaluated the comparative efficacy and safety of these regimens in metastatic, locally advanced and borderline resectable pancreatic cancer.”
In this retrospective study, researchers collected data from 150 patients with metastatic (n = 89) locally advanced (n = 34) and borderline resectable (n = 27) pancreatic cancer who received either FOLFIRINOX (n = 64) or gemcitabine plus nab-paclitaxel (n = 86). Primary end points included overall survival (OS) and safety.
At analysis, median OS was 11 months in the FOLFIRINOX arm and 10 months in the gemcitabine plus nab-paclitaxel arm (P = .38) among patients with metastatic disease. Median OS was 15.5 months in the FOLFIRINOX arm and 17 months in the gemcitabine plus nab-paclitaxel arm (P = .84) among patients with locally advanced disease. Median OS was 37 months in the FOLFIRINOX arm and 16 months in the gemcitabine plus nab-paclitaxel arm (P = .02) among patients with borderline resectable disease, with surgical conversion rates of 66% and 39%, respectively. Grade ≥3 toxicities occurred in 45% of patients in the FOLFIRINOX arm and 21% of patients in the gemcitabine plus nab-paclitaxel arm.
“FOLFIRINOX and [gemcitabine plus nab-paclitaxel] have comparable efficacy in metastatic and locally advanced pancreatic cancer,” concluded Dr Khan et al. “FOLFIRINOX offers a survival benefit in [borderline resectable pancreatic cancer] but with higher toxicity.”
Source:
Khan AM, Muddu VK, Bonda NA, et al. FOLFIRINOX vs. gemcitabine nab-paclitaxel in pancreatic cancer: A real-world single-center analysis of efficacy and safety. J Gastrointest Canc. Published online: August 16, 2025. doi: 10.1007/s12029-025-01287-9
