FOLFIRINOX in Pancreatic Cancer: Risk Factors for Febrile Neutropenia and Severe Neutropenia - Nationwide Study Analysis

Akiko Todaka, Mitsuhito Sasaki, Hideki Ueno, Takuma Goto, Gou Murohisa, Nobumasa Mizuno, Masato Ozaka, Satoshi Kobayashi, Kazuhiro Uesugi, Noritoshi Kobayashi, Hideyuki Hayashi, Kentaro Sudo, Naohiro Okano, Yosuke Horita, Keiko Kamei, Shoko Nanami, Narikazu Boku

Research output: Contribution to journalArticlepeer-review

Abstract

Background/Aim: FOLFIRINOX (FFX) is a standard treatment for patients with advanced pancreatic cancer. However, it often causes serious hematological adverse events. This study aimed to identify the risk factors for febrile neutropenia (FN) and grade 4 (G4) neutropenia during treatment with FFX in the real world. Patients and Methods: We analyzed data obtained from a nationwide multicenter observational study (JASPAC 06) that included 399 patients with unresectable or recurrent pancreatic cancer who received FFX at 27 institutions in Japan. Results: Nadir neutrophil counts occurred from day 8 to day 22 of cycle 1, and granulocyte colony-stimulating factor was administered to over a quarter of the patients in the first cycle. Of 399 patients, FN and G4 neutropenia occurred in 51 (13%) and 108 (27%) patients, respectively. Most FN (83%) and G4 neutropenia (75%) occurred in the first or second cycles. Multivariate logistic regression analyses showed that total bilirubin (TB) > the upper limit of normal range (ULN) and no dose modification from the original regimen were significantly associated with FN, and that TB > ULN, no dose modification from the original regimen, low platelet count (<15×104/μl), and recurrent disease after pancreatectomy were independent risk factors for G4 neutropenia. Conclusion: No dose modification from the original regimen and TB > ULN were risk factors for FN and G4 neutropenia.

Original languageEnglish
Pages (from-to)4115-4123
Number of pages9
JournalAnticancer Research
Volume43
Issue number9
DOIs
StatePublished - Sep 2023
Externally publishedYes

Keywords

  • febrile neutropenia
  • FOLFIRINOX
  • grade 4 neutropenia
  • Pancreatic cancer
  • risk factors

Fingerprint

Dive into the research topics of 'FOLFIRINOX in Pancreatic Cancer: Risk Factors for Febrile Neutropenia and Severe Neutropenia - Nationwide Study Analysis'. Together they form a unique fingerprint.

Cite this