Abstract

Objective: The vast majority of pancreatic carcinoma patients have unresectable or metastatic disease at the time of diagnosis. Therefore, the 5-year survival rate is approximately 10%. FOLFIRINOX is used as a standard first-line therapy in patients with good performance status and as a single agent for patients with poor performance. Our study aimed to compare the combination of FOLFIRINOX and gemcitabine plus platinum-based therapy in the first-line treatment of unresectable metastatic pancreatic cancer. Material and Methods: Patients diagnosed with locally unresectable and metastatic pancreatic cancer at Gazi University Hospital between 01.2012 and 01.2020 were retrospectively screened. Results: The progression-free survival (PFS) and overall survival (OS) did not significantly differ between the FOLFIRINOX and gemcitabine plus platinum groups (p=0.22 and p=0.192, respectively). Moreover, there was no significant difference in the disease control rate (DCR) between the FOLFIRINOX and gemcitabine plus platinum groups (78.6% vs. 73.1%, respectively; p=0.64). The incidence of neutropenia fever and allgrade mucositis, diarrhea, and neuropathy was significantly greater in the FOLFIRINOX group (p=0.036, p=0.021, p=0.009, p=0.021, respectively). However, there were no significant differences in the incidence of Grade 3-4 side effects, interruption due to side effects, or treatment discontinuation (p=0.60, p=0.33, p=0.8, respectively). Conclusion: Although there was an improvement in OS of 4 months in favor of FOLFIRINOX, no statistically significant difference was found in the median OS, PFS, or DCR between patients treated with gemcitabine and patients treated with platinum agents.