Complete pathological response after FOLFIRINOX for locally advanced pancreatic cancer. The beginning of a new era? Case report and review of the literature

GLOBOCAN, 2008 Siegel, 2012, Cancer statistics, CA Cancer J Clin, 62, 10, 10.3322/caac.20138 Hidalgo, 2010, Pancreatic cancer, N Engl J Med, 362, 1605, 10.1056/NEJMra0901557 Gillen, 2010, Preoperative/neoadjuvant therapy in pancreatic cancer: a systematic review and meta-analysis of response and resection percentages, PLoS Med, 7, e1000267, 10.1371/journal.pmed.1000267 Ajani, 2005, Paclitaxel-based chemoradiotherapy in localized gastric carcinoma: degree of pathologic response and not clinical parameters dictated patient outcome, J Clin Oncol, 23, 1237, 10.1200/JCO.2005.01.305 Kuerer, 1999, Clinical course of breast cancer patients with complete pathologic primary tumor and axillary lymph node response to doxorubicin-based neoadjuvant chemotherapy, J Clin Oncol, 17, 460, 10.1200/JCO.1999.17.2.460 Stipa, 2006, A pathologic complete response of rectal cancer to preoperative combined-modality therapy results in improved oncological outcome compared with those who achieve no downstaging on the basis of preoperative endorectal ultrasonography, Ann Surg Oncol, 13, 1047, 10.1245/ASO.2006.03.053 Le Scodan, 2008, Histopathological response to preoperative chemoradiation for resectable pancreatic adenocarcinoma: the French Phase II FFCD 9704-SFRO Trial, Am J Clin Oncol, 31, 545, 10.1097/COC.0b013e318172d5c5 Neoptolemos, 2004, A randomized trial of chemoradiotherapy and chemotherapy after resection of pancreatic cancer, N Engl J Med, 350, 1200, 10.1056/NEJMoa032295 Oettle, 2004, Adjuvant chemotherapy with gemcitabine vs observation in patients undergoing curative-intent resection of pancreatic cancer: a randomised control trial, J Am Med Assoc, 297, 267, 10.1001/jama.297.3.267 Murphy, 2007, Full-dose gemcitabine and concurrent radiotherapy for unresectable pancreatic cancer, Int J Radiat Oncol Biol Phys, 68, 801, 10.1016/j.ijrobp.2006.12.053 Girard, 2010, Estimating optimal dose of twice-weekly gemcitabine for concurrent chemoradiotherapy in unresectable pancreatic carcinoma: mature results of GEMRT-01 phase I trial, Int J Radiat Oncol Biol Phys, 77, 1426, 10.1016/j.ijrobp.2009.06.053 Shibuya, 2011, Phase II study of radiation therapy combined with weekly low-dose gemcitabine for locally advanced, unresectable pancreatic cancer, Am J Clin Oncol, 34, 115, 10.1097/COC.0b013e3181c4c7a8 Whittington, 1995, Protracted intravenous fluorouracil infusion with radiation therapy in the management of localized pancreaticobiliary carcinoma: a phase I Eastern Cooperative Oncology Group Trial, J Clin Oncol, 3, 227, 10.1200/JCO.1995.13.1.227 Combs, 2011, Strategies for preoperative downsizing in patients with local nonresectable pancreatic cancer (German), Chirurgia, 82, 981, 10.1007/s00104-011-2129-1 Morganti, 2010, A systematic review of resectability and survival after concurrent chemoradiation in primarily unresectable pancreatic cancer, Ann Surg Oncol, 17, 194, 10.1245/s10434-009-0762-4 Conroy, 2005, Irinotecan plus oxaliplatin and leucovorin-modulated fluorouracil in advanced pancreatic cancer – a Groupe Tumeurs Digestives of the Federation Nationale des Centres de Lutte Contre le Cancer study, J Clin Oncol, 23, 1228, 10.1200/JCO.2005.06.050 Conroy, 2011, FILFIRINOX versus gemcitabine for metastatic pancreatic cancer, N Engl J Med, 364, 1817, 10.1056/NEJMoa1011923 Varadhachary, 2006, Borderline resectable pancreatic cancer: definitions, management, and role of preoperative therapy, Ann Surg Oncol, 13, 1035, 10.1245/ASO.2006.08.011 Mahaseth, 2012, Safety and efficacy of modified FOLFIRINOX in pancreatic cancer; a retrospective experience, J Clin Oncol, 30, e14614, 10.1200/jco.2012.30.15_suppl.e14614 Peddi, 2012, Multi-institutional experience with FOLFIRINOX in pancreatic adenocarcinoma, JOP, 13 Marthey, 2012, FOLFIRINOX for locally advanced pancreatic adenocarcinoma. Results of an AGEO multicentric prospective study, Ann Oncol, 23, 716 Vasile, 2012, Neoadjuvant modified FOLFOXIRI in locally advanced pancreatic cancer, Ann Oncol, 23, 726 Hosein, 2012, A retrospective study of neoadjuvant FOLFIRINOX in unresectable or borderline-resectable locally advanced pancreatic adenocarcinoma, BMC Cancer, 12, 199, 10.1186/1471-2407-12-199 Gunturu, 2013, FOLFIRINOX for locally advanced and metastatic pancreatic cancer: single institution retrospective review of efficacy and toxicities, Med Oncol, 30, 361, 10.1007/s12032-012-0361-2 Faris, 2013, FOLFIRINOX in locally advanced pancreatic cancer: the Massachusetts General Hospital Cancer Center Experience, Oncologist, 18, 543, 10.1634/theoncologist.2012-0435 Hartlapp, 2013, Complete pathological remission of locally advanced, unresectable pancreatic cancer (LAPC) after intensified neoadjuvant chemotherapy, Onkologie, 36, 123, 10.1159/000348527 Tanaka, 2010, Undifferentiated carcinoma of the pancreas with/without osteoclast-like giant cells, Pathol Case Rev, 15, 210, 10.1097/PCR.0b013e3181ffb8ac