Impact of Weight Loss After FOLFIRINOX Treatment on Survival in Patients with Unresectable Advanced or Recurrent Pancreatic Cancer

Weight loss following chemotherapy initiation may reduce treatment tolerance and decrease survival duration. The association between weight loss and survival outcomes after FOLFIRINOX (FFX) therapy remains limited. This retrospective study investigated the impact of 5％ < weight loss (2％ < weight loss for patients with BMI < 20) 1 month after starting FFX therapy as the first-line treatment for unresectable advanced or recurrent pancreatic cancer. Among the 65 patients, 33 (50.8％) experienced weight loss 1 month after initiating FFX therapy. Patients with weight loss had significantly shorter overall survival, with a median overall survival (mOS) of 216 days compared with 384 days in patients without weight loss (P = 0.006). Similarly, validation using propensity score matching confirmed that weight loss was associated with shorter survival, with a mOS of 258 days compared with 512 days in patients without weight loss (P = 0.035). These findings indicate that early weight loss 1 month after FFX therapy initiation may be a predictor of shorter survival, underscoring the importance of implementing early interventions to manage weight loss alongside FFX treatment.