Pancreatic cancer and FOLFIRINOX: A new era and new questions

Robert De W. Marsh, Mark S. Talamonti, Matthew Harold Katz, Joseph M. Herman

Research output: Contribution to journalReview articlepeer-review


FOLFIRINOX (FFX) was introduced to clinical practice in 2010 following publication of the PRODIGE 4/ACCORD 11 study, which compared this novel regimen to gemcitabine in metastatic pancreatic cancer. Median overall survival, progression-free survival, and objective responses were all superior with FFX and there was improved time to definitive deterioration in quality of life. Despite initial concerns over toxicity, there has been rapid uptake of this regimen, both revolutionizing management and opening the door to innovative research. As experience with FFX has accrued, many questions have arisen including the management of toxicities, the impact of frequent modifications, the optimal number of cycles, integration with other regimens and modalities, interpretation of radiologic and serologic response, utility of molecular signatures, and potential benefit in unique clinical settings such as pre- and postsurgery. This review will closely examine these issues, not only to summarize current knowledge but also to fuel scientific debate.

Original languageEnglish (US)
Pages (from-to)853-863
Number of pages11
JournalCancer medicine
Issue number6
StatePublished - Jun 1 2015


  • Chemotherapy
  • Genomics
  • Modifications
  • Pancreatic cancer
  • Toxicity

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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