US oncologists see FOLFIRINOX as the most efficacious for advanced pancreatic cancer

The majority of surveyed US oncologists (57%) identified FOLFIRINOX* as the most efficacious treatment for advanced pancreatic cancer, when compared to other currently available agents, says research and advisory firm Decision Resources. Patients with advanced pancreatic cancer who received FOLFIRINOX experienced a considerably longer median overall survival compared with patients given gemcitabine Eli Lilly’s Gemzar (gemcitabine generics) monotherapy.

The findings from Decision Resources’ analysis of the pancreatic cancer drug market also reveal that, based on the pivotal Phase III PRODIGE-4/ACCORD-11 clinical trial data, interviewed thought leaders describe FOLFIRINOX as a milestone in pancreatic cancer treatment. However, contrary to the view of surveyed oncologists, the majority of surveyed managed care organizations’ (MCOs) pharmacy directors (55%) consider gemcitabine plus erlotinib (OSI/Roche/Genentech/Chugai’s Tarceva) the most efficacious treatment for advanced pancreatic cancer. Gemcitabine plus erlotinib, the first therapy to demonstrate a statistically-significant improvement in survival over gemcitabine monotherapy in a Phase III clinical trial, improved median overall survival by approximately 12 days over monotherapy using gemcitabine.

“Surveyed pharmacy directors likely perceive any increase in survival, however slight, as an improvement, and they may not be familiar with the FOLFIRINOX data as only 10% of surveyed pharmacy directors selected FOLFIRINOX as the most efficacious treatment for advanced pancreatic cancer,” said Decision Resources analyst Rachel Webster, adding. “Only 15% of surveyed oncologists chose gemcitabine plus erlotinib as the most efficacious treatment which is likely because, as the majority of interviewed experts tell us, the meager improvement in survival over gemcitabine is not clinically beneficial. Also, given erlotinib’s added toxicity and cost, many interviewed physicians say they choose not to prescribe the regimen.”