Induction chemotherapy with FOLFIRINOX in pancreatic cancer and then? Experience with a novel scheme of maintenance, treatment pause and re-induction

Introduction: Chemotherapy regimens for locally advanced or metastatic pancreatic ductal adenocarcinoma (PDAC) have changed since the introduction of FOLFIRINOX (5-fluoruracil (5FU/LV), Oxaliplatin, Irinotecan and Leucovorin) which confer a significant survival benefit compared to gemcitabine-based monotherapy. Increased toxicity, mainly sensory peripheral neuropathy, limits its use and the number of applied chemotherapy cycles. In analogy to chemotherapy strategies in colon cancer we used a scheme of induction, maintenance, treatment pause and re-induction therapy in locally advanced or metastatic PDAC to allev…