AI Article Synopsis
- Two patients with pancreatic cancer—one receiving second-line treatment and the other third-line—were planned to be treated with FOLFIRINOX, despite both having UGT1A1 polymorphisms that increase the risk of toxicity from certain medications, including irinotecan.
- FOLFIRINOX was administered cautiously, and even though both patients experienced Grade 4 neutropenia, it was managed effectively with G-CSF and dose adjustments.
- No severe diarrhea or other serious side effects occurred, highlighting the need for more research on the use of FOLFIRINOX in patients with high-risk UGT1A1 polymorphisms.
Article Abstract
Treatment containing FOLFIRINOX was planned to be administered to a 51-year-old man with locally advanced pancreatic cancer as second-line chemotherapy and to a 66-year-old woman with recurrent pancreatic cancer as third-line chemotherapy in their treatments. Since both patients were revealed to harbor UGT1A1 polymorphisms, which were highly associated with irinotecan-induced toxicity(the former: UGT1A1 *6/*28, the latter: UGT1A1*6/*6), there was no alternative hopeful treatment other than FOLFIRINOX for them. Therefore, FOLFIRINOX was administered very carefully. Although both patients showed Grade 4 neutropenia during the initial course, it was controllable with G-CSF administration and following stepwise reduction of the irinotecan dose. Severe diarrhea and other adverse events were not observed in both cases. Since the determined regimen of FOLFIRINOX for patients with high-risk UGT1A1 polymorphisms has not been developed yet, it would be critical to accumulate and review an experience of FOLFIRINOX administration for these patients.
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