1. Nanoliposomal irinotecan with fluorouracil and folinic acid, FOLFIRINOX, and S-1 as second-line treatment for unresectable pancreatic cancer after gemcitabine/nab-paclitaxel.
- Author
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Shibuki T, Otsuka T, Shimokawa M, Nakazawa J, Arima S, Fukahori M, Miwa K, Okabe Y, Koga F, Ueda Y, Kubotsu Y, Makiyama A, Shimokawa H, Takeshita S, Nishikawa K, Komori A, Otsu S, Hosokawa A, Sakai T, Oda H, Kawahira M, Arita S, Honda T, Taguchi H, Tsuneyoshi K, Kawaguchi Y, Fujita T, Sakae T, Nio K, Ide Y, Ureshino N, Shirakawa T, Mizuta T, and Mitsugi K
- Subjects
- Humans, Male, Female, Middle Aged, Aged, Retrospective Studies, Oxonic Acid administration & dosage, Oxonic Acid therapeutic use, Tegafur administration & dosage, Tegafur therapeutic use, Adult, Liposomes, Treatment Outcome, Aged, 80 and over, Pancreatic Neoplasms drug therapy, Pancreatic Neoplasms pathology, Pancreatic Neoplasms mortality, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Leucovorin therapeutic use, Leucovorin administration & dosage, Irinotecan administration & dosage, Irinotecan therapeutic use, Paclitaxel administration & dosage, Paclitaxel therapeutic use, Fluorouracil administration & dosage, Fluorouracil therapeutic use, Gemcitabine, Drug Combinations, Albumins administration & dosage, Deoxycytidine analogs & derivatives, Deoxycytidine administration & dosage, Deoxycytidine therapeutic use, Oxaliplatin administration & dosage, Oxaliplatin therapeutic use
- Abstract
This study aimed to compare second-line treatment outcomes for patients with unresectable pancreatic cancer previously treated with gemcitabine plus nab-paclitaxel (GnP) therapy. We conducted an integrated analysis of two retrospective studies included 318 patients receiving nanoliposomal irinotecan + 5-fluorouracil/folinic acid (NFF) (n = 102), S-1 (n = 57), or FOLFIRINOX (n = 14) as second-line treatment. Median overall survival (OS) in the NFF group was 9.08 months, significantly better than S-1 (4.90 months, P = 0.002). FOLFIRINOX had a median OS of 4.77 months, not statistically different from NFF. Subgroup analyses of OS indicated NFF was generally superior, however, a statistical interaction was observed between the treatment regimen in serum Alb < 3.5 g/dL (P = 0.042) and serum CRP ≥ 0.3 mg/dL (P = 0.006). Median progression-free survival (PFS) was 2.93 months for NFF, significantly better than S-1 (2.53 months, P = 0.024), while FOLFIRINOX had a comparable PFS (3.04 months, P = 0.948). Multivariate analysis identified the serum CRP, serum CA19-9, duration of first-line GnP therapy, and use (yes/no) of S-1 for second-line treatment as independent predictors for OS. This study concludes that second-line NFF therapy demonstrated a more favorable OS compared to S-1 therapy, however, it is still important to consider the patient background characteristics while selecting the most appropriate treatment., (© 2024. The Author(s).)
- Published
- 2024
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