KEY TAKEAWAYS
- In two trials (BACAP and GEMCIPANC), patient data were studied to determine the effectiveness of FOLFIRINOX/FOLFOX regimens in PDAC.
- The patients with FOLFIRINOX/FOLFOX treatments who tested positive for F/FX showed notably longer PFS and OS rates.
- Those treated with gemcitabine didn’t exhibit significant differences in survival outcomes based on their F/FX test results.
In 2022, researchers introduced the GemciTest, a blood-based RNA signature that predicts the response to gemcitabine-centric initial treatments in pancreatic ductal adenocarcinoma (PDAC) patients (pts). The study’s objective was to evaluate the effectiveness of a complementary blood-based RNA signature (F/FX) to predict the response to FOLFIRINOX/FOLFOX regimens in advanced pancreatic adenocarcinoma.
Researchers conducted discovery and validation phases to validate their findings clinically, involving 164 untreated late-stage PDAC pts (mean age: 68.7 years; age range: 37-88). These pts were administered either gemcitabine or fluoropyrimidine-based treatments. The F/FX test identifies the expression rates of ten specific genes via the real-time PCR procedure.
For those treated with FOLFIRINOX/FOLFOX (n=90), pts who tested positive for F/FX (31.1%) witnessed a notably extended progression-free survival (PFS) and median overall survival (OS). A Pearson correlation coefficient of 0.73 was found between OS and PFS. However, gemcitabine-treated pts (n=74) didn’t exhibit any substantial variance in PFS and OS when comparing positive and negative F/FX results.
The F/FX highlighted the potential benefits of using a blood-based RNA signature as a less invasive method to enhance survival rates and tailor treatment in PDAC pts undergoing FOLFIRINOX/FOLFOX as an initial treatment. Even though these findings are encouraging, a prospective study is necessary to validate them, especially when considering pts with non-resectable locally advanced and metastatic tumors.
Source: https://www.annalsofoncology.org/article/S0923-7534(23)00622-1/fulltext
Clinical Trials: https://classic.clinicaltrials.gov/ct2/show/NCT03599154
https://classic.clinicaltrials.gov/ct2/show/NCT02818829
Piquemal, D., Noguier, F., Bournet, B., Ghiringhelli, F., Pierrat, F., Canivet, C., Bertaut, A., Bruno, R., Evesque, L., Gamez, A., Cros, J., Lepage, C., François, E., Louvet, C., Vincent, J., Hennequin, A., Bengrine, L., Afchain, P., Trouilloud, I., Bachet, J. PREDICTIVE VALUES OF BLOOD-BASED RNA SIGNATURE FOR THE FOLFIRINOX/FOLFOX RESPONSE IN ADVANCED PANCREATIC CANCER. https://doi.org/10.1016/j.annonc.2023.04.480
