FOLFIRINOX improves PFS vs gemcitabine in locally advanced pancreatic cancer (NEOPAN trial)

In May 2025, the NEOPAN (PRODIGE 29/UCGI 26) Phase III trial reported that FOLFIRINOX significantly improved progression-free survival (PFS) over gemcitabine in patients with locally advanced pancreatic cancer (LAPC). Median PFS was extended to 12.1 months versus 8.5 months for gemcitabine (HR 0.69; P<0.001). The trial enrolled over 400 patients across Europe and evaluated long-term outcomes including resectability and quality of life metrics. Although toxicity was higher with FOLFIRINOX (notably neutropenia and neuropathy), supportive care measures and dose adjustments allowed most patients to complete treatment. Importantly, a higher percentage of patients in the FOLFIRINOX arm went on to receive potentially curative surgery, further supporting its use in borderline or locally advanced disease. Experts consider this study pivotal in shifting standard of care for LAPC, particularly in younger or fitter patients, and guideline updates are expected following this publication.‍

Citation: https://www.onclive.com/view/folfirinox-significantly-improves-pfs-over-gemcitabine-in-locally-advanced-pancreatic-carcinoma

Implication: Expands FOLFIRINOX’s use in LAPC and reinforces its role in earlier-stage disease.

‍