FOLFIRINOX versus gemcitabine-based therapy for pancreatic ductal adenocarcinoma: Lessons from patient-derived cell lines

Background/Aim: FOLFIRINOX [fluorouracil (5- FU), irinotecan, oxaliplatin] and gemcitabine plus nabpaclitaxel are standard treatments for patients with pancreatic ductal adenocarcinoma (PDAC). Despite efficacy rates of less than 32%, evidence is lacking to guide the use of one drug over the other. Herein, we compared the sensitivity of patient-derived PDAC cell lines to each of these regimens. Materials and Methods: Changes in the growth of 19 low-passage patientderived PDAC cell lines were evaluated in response to treatment with FOLFIRINOX and gemcitabine plus paclitaxel (Gem-Pac). Results: Six cell lines exhibited optimal sensitivity (high E_Maxand low GI₅₀) to FOLFIRINOX and three cell lines exhibited optimal sensitivity to Gem-Pac. Several cell lines that were optimally sensitive to one drug regimen exhibited very poor response to the other. Conclusion: Further characterization of cancer cells exhibiting preferential sensitivity to each of these regimens may allow the identification of biomarkers to guide the selection of appropriate chemotherapy for a given patient.