One for all.

Top Line: This summer ASCO brought us initial reports that adjuvant FOLFIRINOX leads to unprecedented survival times for patients with resected pancreatic cancer.
The Study: The full pub of PRODIGE-24 is hot off the press today. Spoiler alert: We’ve already learned that modified FOLFIRINOX not only significantly improved the primary endpoint of disease-free survival but also achieved an incredible median overall survival of 54 months, as compared to the otherwise respectable 35 months with gemcitabine. But maybe these French and Canadian centers pulled a fast one by enrolling only les meilleures patients, so here we learn more deets. When considering the feared toxicities of FOLFIRINOX, it’s important to note that 20% of all enrollees were 70 years or older, though everyone was ECOG 1 or less. Most remarkably, three-quarters had node-positive disease and a whopping 43% had R1 resections defined as tumor cells within 1 mm of the margin.
Bottom Line: Adjuvant FOLFIRINOX is the new standard following any grossly-resected pancreatic cancer for anyone with a reasonable performance status because it improves survival outcomes across the board. | Conroy, N Engl J Med 2018


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