Enhanced Survival Outcomes with FOLFIRINOX in Initial Metastatic Pancreatic Cancer: Single-Center
Emir Sokolovic1, Amil Druzic1*, Una Stojanovic1 , Elma Kapisazovic1, Emina Borovac-Gurda1, Jasmina Redzepagic4, Amina Aljic3 , Mattar Layan3 , Sejla Ceric5 , Berisa Hasanbegovic1, Anes Pasic2 , Semir Beslija1
1 Clinic of Oncology, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
2 Clinic of Oncology, Clinical Center University of Maribor, Maribor, Republic of Slovenia
3 Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
4 Clinic of Pathology, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
5 Clinic for Nuclear Medicine, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
Corresponding Author: Amil Družić, MD. Clinic of Oncology, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina; E-mail: amil.druzic@gmail.com; Phone: +387 66260904 ; ORCID ID: 0009-0008-5198-6902.
Cite this article: Sokolovic E, Druzic A, Stojanovic U, Kapisazovic E, Borovac-Gurda E, Redzepagic J, et al. Enhanced Survival Outcomes with FOLFIRINOX in Initial Metastatic Pancreatic Cancer: Single-Center Study. Sar Med J. 2024; 1(2): Online ahead of print. 
10.70119/0020-24
Pages: 75 – 81 / Published online: 27 December 2024
Original submission: 15 October 2024; Revised submission: 17 November2024; Accepted: 29 November 2024
Abstract
Introduction. The aim of this article is to evaluate the effi cacy and outcomes of FOLFIRINOX as a fi rst-line treatment for initial metastatic pancreatic cancer patients at the Clinical Center University of Sarajevo.
Methods. The research presents a retrospective analysis was conducted on 33 patients treated with FOLFIRINOX, between January 2021 and January 2023. Baseline characteristics, tumor markers (CEA, CA 19-9, CA 125), neutrophil-to-lymphocyte ratio (NLR), neutrophil-to-platelet ratio (NPR) and initial metastatic site were evaluated using Cox regression analysis in order to identify predictive and prognostic factors for progression-free survival (PFS) and overall survival (OS).
Results. The median age of patients was 64 (range 38-76). There were 18 males and 15 females. The median OS was 21.7 months (95% CI, 10.5-32.9) and the median PFS was 10.0 months (95% CI, 8.2-11.8). A statistically signifi cant negative correlation was found between NLR and OS (r=-0.464, p=0.045). Patients with initial liver metastasis had a numerically worse median OS (16.3 months, 95% CI, 5.1-27.5), compared to those with non-liver metastasis (OS not reached, p=0.058). Tumor markers, NLR, NPR, and initial metastatic site were not independent predictors of PFS and OS.
Conclusion. FOLFIRINOX demonstrates signifi cant effi cacy in treating metastatic pancreatic cancer in a real-world setting. Personalized approaches, including genetic profi ling and microbiome analysis, along with AI integration, off er promising avenues to enhance treatment outcomes and quality of life for patients.
Keywords: metastatic pancreatic cancer, enhanced outcomes, overall survival, progression free survival.
