Earlyincrease of CA 19-9 inadvanced pancreatic cancer receiving folfirinox is it a sign of efficacy ?

Abstract FRE

Advanced pancreatic cancer (APC), one of the most aggressive tumors, was considered to be resistant to chemotherapy for decades.

FOLFIRINOX (5-FU, leucovorin, irinotecan and oxaliplatin) regimen showed an improvement of quality of life and overall survival in APC patients with good performance status (ECOG < 2).

Material and methods : Seven patients diagnosed with APC, during a six-month period, received FOLFIRINOX as first line treatment.

Tumor measurement was assessed every two months and CA 19-9, the specific tumor marker of pancreatic cancer, was assessed every two weeks at every cycle.

Results : Three patients out of seven receiving FOLFIRINOX experienced an early and transitory increase of CA 19-9 after the first two cycles resulting in a considerable response with a median survival of 15 months and suggesting a model of tumor release syndrome.

Conclusion: This phenomenon of early and transitory increase of CA 19-9 in APC could reflect the high efficacy of FOLFIRINOX and could predict better outcome in these patients.