Top Line: PRODIGE 24 set the standard for adjuvant therapy for resected pancreatic cancer.
The Study: As a reminder, 493 patients with resected pancreatic adenocarcinoma were randomized to receive adjuvant gemcitabine or FOLFIRINOX. FOLFIRINOX significantly improved median OS to 54.4 months compared to 35.0 months with gemcitabine. We now have long-term outcomes from PRODIGE 24, which show that FOLFIRINOX maintains superiority over gemcitabine. At 5 years, the rate of disease-free survival was significantly higher with FOLFIRINOX (26.1% v 19.0%) as was the rate of OS (43.2% v 31.4%). Patterns of failure showed that the most common pattern of recurrence in both groups was distant metastasis (54.3% v 46.9%) with FOLFIRINOX patients having more lung metastases and fewer liver or peritoneal metastases. Just over 20% in each arm had locoregional only recurrence. Over a quarter of patients in the FOLFIRINOX arm (27.2%) had surgery or radiation to treat relapse.
TBL: Adjuvant FOLFIRINOX for resected pancreatic adenocarcinoma has a 5-year overall survival rate of 43.2%. | Conroy, JAMA Oncol 2022