Real Life Data and Outcome of FOLFIRINOX Use in Metastatic Pancreatic Cancer Patients in General Hospitals in the Netherlands.

INTRODUCTION: Pancreatic cancer is one of the five most common causes of cancer mortality in developed countries. In patients with metastatic disease, the most frequent treatment used is FOLFIRINOX, which is associated with moderate toxicity which could influence quality of life. The efficacy of FOLFIRINOX in a general population in the Netherlands has not been subject of research before, and therefore, this research has been set up in order to investigate what the real-life benefits of FOLFIRINOX are in a population with metastatic pancreatic cancer (mPC) treated in three general hospitals in the Netherlands. METHODS: The data used in this study was collected by patient records leading to a noninterventional retrospective cohort study. Eighty-six patients, over 18 years of age, diagnosed with mPC between the years 2015 and 2022 and treated with FOLFIRINOX at Maasstad Hospital in Rotterdam, Amphia Hospital in Breda, or Catharina Hospital in Eindhoven, were included in the study. Kaplan-Meier models were used in order to represent survival outcomes. RESULTS: The results showed a median overall survival of 228 days (IQR 118-355). Only 14.0% (n = 12) completed the first-line treatment, and 51.2% (n = 44) of patients stopped treatment before or during cycle 6. Toxicity is highest, grade 3, after the first cycle but remains high for grade 1 and 2 during all treatment cycles. CONCLUSION: Survival rates for patient with metastatic pancreatic cancer treated with FOLFIRINOX were worse in our study population than in comparative studies.

Nasal inflammatory and respiratory parameters in human volunteers during and after repeated exposure to chlorine.

The objectives of this study were: 1) to determine if chlorine exposure at low levels induces nasal effects in humans as it does in rodents; and 2) to establish a possible occurrence of respiratory effects in human volunteers exposed to chlorine vapour at concentrations of 0, 0.1, 0.3 and 0.5 ppm. The study was conducted in a double-blind fashion in 8 male volunteers using a repeated measures design, with randomly selected exposure sequences. Subjects were exposed for 6 h x day(-1) on 3 consecutive days to each of the 4 exposure conditions. In nasal lavage, interleukin-8 (IL-8), albumin, total cell number, and percentages of neutrophils, lymphocytes, monocytes, eosinophils, and epithelial cells were determined. The lung function parameters that were analysed included forced vital capacity (FVC), forced expiratory volume in first second (FEV1), FEV1/FVC ratio, and maximal mid expiratory flow (MMEF). Data analysis was limited to 7 subjects since one volunteer decided to stop participating for reasons not related to the study. Nasal lavage measurements did not support an inflammatory response or irritant effects on the nasal epithelium. For FVC, FEV1, and FEV1/FVC, no significant differences were found. MMEF was significantly different between the 0 and 0.5 ppm exposure, but this was attributed to an unexplained shift in baseline values during control (0 ppm) exposure. The present data does not support an inflammatory effect in the nose nor shows changes in respiratory function at repeated exposure up to 0.5 ppm. This discrepancy with previous data in rodents can be attributed at least in part to differences in respiratory tract airflow characteristics.