A phase II study of neoadjuvant liposomal irinotecan with 5-FU and oxaliplatin (NALIRIFOX) in pancreatic adenocarcinoma

For patients with localized pancreatic cancer with minimal vascular involvement, optimal survivability requires a multidisciplinary approach of surgical resection and systemic chemotherapy. FOLFIRINOX is a combination chemotherapy regimen that offers promising results in the perioperative and metastatic settings; however, it can cause significant adverse effects. Such toxicity can negatively impact some patients, resulting in chemotherapy discontinuation or surgical unsuitability. In an effort to reduce toxicities and optimize outcomes, this investigation explores the safety and feasibility of substituting liposomal irinotecan (nal-IRI) for nonliposomal irinotecan to improve tumor drug delivery and potentially reduce toxicity. This regimen, NALIRIFOX, has the potential to be both safer and more effective when administered in the preoperative setting. For patients with pancreatic cancer with little to no cancer near the blood vessels, the best life expectancy usually requires surgery and chemotherapy. FOLFIRINOX is a chemotherapy medicine that offers promising results for both patients getting surgery and for patients with widespread disease. However, it can cause harmful side effects. The side effects can be so bad that the chemotherapy has to be stopped or that surgery is no longer possible. In order to reduce the harmful side effects and improve outcomes, this investigation looks into the safety and practicality of using a different version of one of the medicines. The different version hopes to improve drug delivery and reduce harmful side effects. This regimen, NALIRIFOX, can be safer and more effective in patients awaiting surgery.Clinical Trial Registration: UF-STO-PANC-004 (NCT03483038) (ClinicalTrials.gov) NALIRIFOX, a Phase II clinical trial for the treatment of resectable and borderline resectable pancreatic cancer. The regimen includes novel liposomal irinotecan in combination with 5-fluorouracil, leucovorin and oxaliplatin. Enrolling in multiple sites (NCT03483038).

Automated summary

For patients with localized pancreatic cancer, a combination of surgical resection and systemic chemotherapy is essential for optimal survivability. While FOLFIRINOX has shown promising results, its adverse effects can be significant. This investigation explores the use of liposomal irinotecan (nal-IRI) to improve drug delivery and reduce toxicity. The NALIRIFOX regimen has the potential to be safer and more effective, especially in the preoperative setting.