Dr. Laber on the PRODIGE 35-PANOPTIMOX Trial in Metastatic Pancreatic Cancer

Damian Laber, MD
Published: Tuesday, Mar 12, 2019



Damian Laber, MD, hematologist/oncologist, senior member, Moffitt Cancer Center, discusses the PRODIGE 35-PANOPTIMOX trial in metastatic pancreatic cancer.

In patients with metastatic pancreatic cancer, FOLFIRINOX can be a difficult regimen to tolerate. As such, the PRODIGE 35-PANOPTIMOX trial was designed to determine if certain chemotherapy agents could be dropped after a certain length of exposure in order to increase the regimen’s tolerability. In the trial, patients were randomized to 1 of 3 arms: those who would receive 6 months of FOLFIRINOX (Arm A); 4 months of FOLFIRINOX followed by 5-fluorouracil/leucovorin (Arm B); or gemcitabine monotherapy alternating with FOLFIRINOX. In Arm B, FOLFIRINOX was reintroduced if patients progressed, says Laber.

Arm C was found to be inferior to both Arms A and B. Further, arms A and B were comparable in terms of progression-free survival as well as response rates. However, this was a phase II study, cautions Laber. Although this offers another option to choose from in the treatment of patients who are unable to complete 6 months of FOLFIRINOX, survival data from the trial has not yet been reported.
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Damian Laber, MD, hematologist/oncologist, senior member, Moffitt Cancer Center, discusses the PRODIGE 35-PANOPTIMOX trial in metastatic pancreatic cancer.

In patients with metastatic pancreatic cancer, FOLFIRINOX can be a difficult regimen to tolerate. As such, the PRODIGE 35-PANOPTIMOX trial was designed to determine if certain chemotherapy agents could be dropped after a certain length of exposure in order to increase the regimen’s tolerability. In the trial, patients were randomized to 1 of 3 arms: those who would receive 6 months of FOLFIRINOX (Arm A); 4 months of FOLFIRINOX followed by 5-fluorouracil/leucovorin (Arm B); or gemcitabine monotherapy alternating with FOLFIRINOX. In Arm B, FOLFIRINOX was reintroduced if patients progressed, says Laber.

Arm C was found to be inferior to both Arms A and B. Further, arms A and B were comparable in terms of progression-free survival as well as response rates. However, this was a phase II study, cautions Laber. Although this offers another option to choose from in the treatment of patients who are unable to complete 6 months of FOLFIRINOX, survival data from the trial has not yet been reported.



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