Comparison of Frontline FOLFIRINOX with Fluorouracil-Based and Gemcitabine-Based Chemotherapies in Metastatic Ampullary Adenocarcinoma: A Multicenter Study by the Turkish Oncology Group (TOG)
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background: Adenocarcinoma arising from the ampulla of Vater is an extremely rare neoplasm, and there are limited data regarding frontline therapy for metastatic disease. We investigated the outcomes of first-line treatment with FOLFIRINOX by comparing it with other treatments in patients with advanced ampullary adenocarcinoma. Methods: We included 123 patients with advanced ampullary adenocarcinoma who were treated with frontline FOLFIRINOX (n = 32), fluorouracil (FU)-based chemotherapy (n = 20), and gemcitabine-based chemotherapy (n = 65) between August 2007 and January 2024 in this retrospective study. The median progression-free survival (mPFS) and overall survival (mOS) according to treatment and clinicopathological features were calculated using the Kaplan–Meier method. Results: The median age of the patients was 62 years (range, 36–78), and 75,6% of the patients had an ECOG performance status of 0–1. The mOS were 13 months (95% CI, 10.6–14.4), 11 months (95% CI, 10.6–14.4), and 12 months (95% CI, 10.6–14.4), respectively [p = 0.865]. There were no significant differences in OS among the chemotherapeutic agents according to histological subtypes. However, FOLFIRINOX and FU-based treatments appeared more effective in the intestinal subtype, while gemcitabine-based therapies were less effective. In the pancreaticobiliary subtype, FU-based therapies yielded a shorter outcome compared to FOLFIRINOX and gemcitabine-based therapies. Grade 3 or 4 hematologic toxicities were higher in patients treated with FOLFIRINOX. Conclusions: In advanced ampullary adenocarcinoma, despite higher toxicity, frontline FOLFIRINOX showed a trend toward an OS benefit in the intestinal subtype while providing a similar outcome in the pancreaticobiliary subtype.
Source: Journal of Clinical Medicine
DOI: 10.3390/jcm14165868
Authors: Ali Kalem, Tulay Kus, Savas Gokcek, Ilkay Tugba Unek, Taha Koray Sahin, Omer Dizdar, Muhammed Fatih Sagıroglu, Hatice Bolek, Yuksel Urun, Sendag Yaslıkaya, Ertugrul Bayram, Nadiye Sever, Ibrahim Vedat Bayoğlu, Omer Acar, Atike Pınar Erdogan, Seray Saray, Berkan Karabuga, Ulku Arslan Yalcıntas, Safa Can Efil, Mehmet Ali Nahit Sendur, Talat Aykut, Murat Araz, Tugce Kubra Gunes, Melike Ozcelik, Mustafa Seyyar, Gokmen Aktas, Suayib Yalcın
Institutions: Gaziantep University, Dokuz Eylül University, Hacettepe University, Gaziantep Şehir Hastanesi, Ankara University, Cukurova University, Marmara University, Manisa Celal Bayar University, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara Yıldırım Beyazıt University, Necmettin Erbakan University, Ümraniye Eğitim ve Araştırma Hastanesi
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,137
OpenAlex ID: W4413351163