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Neutropenia (NEU) is a common side effect of chemotherapy. Most patients undergoing chemotherapy experience reduced red and white blood cells as well as reduced platelet production. What is not common is the degree of neutropenia a patient experiences. The peculiar aspect of the study linked and excerpted below is the relationship with severe neutropenia and overall survival (OS).
According to the study below, pancreatic patients undergoing the FOLFIRINOX regimen who experience stage 3 or 4 neutropenia lived longer that pancreatic cancer patients who did not experience severe neutropenia.
As per usual, I have an opinion of the study findings below. I don’t see the study being about the side effects of FOLFIRINOX as being the issue, I see the study highlighting how patients react to the FOLFIRINOX chemo. Folfirnox is really toxic therapy. My view is that if a person is experiencing severe neutropenia, then he or she is reacting fully to this chemo regimen.
Consider curcumin as an integrative therapy to enhance the effacacy of chemo while moderating side effects.
To put it in personal terms, I had an autologous stem cell transplant. I handled the aggressive chemotherapy well. I had some side effects but overall, I’d say I did sailed through my ASCT. I relapsed in less than a year. Did the fact that I weathered aggressive toxicity well mean that the chemo wasn’t attacking the cancer…thoroughly or fully?
The outcomes below, for me anyway, point to the importance of throwing a spectrum of therapies at pancreatic cancer- conventional (FDA approved), integrative (to enhance the conventional chemo), complementary therapies. Hit this cancer with everything you’ve got.
Have you been diagnosed with pancreatic cancer? Scroll down the page, post a question or comment and I will reply to you ASAP.
“Among patients with pancreatic cancer being treated with modified FOLFIRINOX, those who develop severe NEU have significantly longer median overall survival, as well as longer time to treatment failure, compared with those who do not develop severe neutropenia….
Severe NEU is associated with longer overall survival (OS) in patients with pancreatic cancer who receive modified FOLFIRINOX therapy, according to the results of new study…
Modified FOLFIRINOX is a regimen that reduces the doses in the FOLFIRINOX regimen to mitigate the occurrence of adverse events. Although a decrease in adverse events is beneficial to enhance a patient’s quality of life, some studies have identified that patients with more severe NEU have actually survived longer. In order to confirm if the incidence of severe NEU is related to OS in patients with pancreatic cancer, researchers compared the survival outcomes of patients with and without severe NEU…
Among the 51 patients enrolled to receive modified FOLFIRINOX, 39 (76.5%) of them developed severe (grade 3 or higher) NEU Patients who developed severe neutropenia had significantly longer median OS compared with patients who did not (21.3 months vs 8.9 months; P = .02). These patients also had longer time to treatment failure than those without severe NEU (7.0 months vs 3.7 months; P = .079)…
Although most of the findings observed were not significant, investigators concluded that there was an undeniable relationship between survival and the incidence of severe NEU in patients with pancreatic cancer treated with modified FOLFIRINOX. Use of the incidence of severe NEU may serve as an indicator of survival outcomes for these patients who receive modified FOLFIRINOX.”
“Pancreatic cancer is among the leading cause of deaths due to cancer with extremely poor prognosis. Gemcitabine is being used in the treatment of patient with pancreatic ductal adenocarcinoma (PDAC), although, the response rate is bellow 12%.
A recent phase III trial revealed that FOLFIRINOX could be an option for the treatment of metastatic PDAC patients, although it is associated with increased toxicity.
Therefore, identification of novel agents that either improves gemcitabine activity, within novel combinatorial approaches, or with a better efficacy than gemcitabine is warranted. The antitumor activity of curcumin in several tumors, including prostate, breast and colorectal cancers have investigated.
A recent phase II trial explored the effects of curcumin in advanced pancreatic cancer patient. They found that oral curcumin was well tolerated. Another trial showed the activity of 8,000 mg of curcumin in combination with gemcitabine in patients with advanced pancreatic cancer.
This review summarizes the current knowledge about possible molecular mechanisms of curcumin in PDAC with particular emphasis on preclinical/clinical studies in pancreatic cancer treatment. J. Cell. Biochem. 118: 1634-1638, 2017. © 2017 Wiley Periodicals, Inc.”