Liposomal irinotecan plus fluorouracil/leucovorin versus FOLFIRINOX as the second-line chemotherapy for patients with metastatic pancreatic cancer: a multicenter retrospective study of the Korean Cancer Study Group (KCSG)
- Abstract
- Background: There is no clear consensus on the recommended second-line treatment for patients with metastatic pancreatic cancer who have disease progression following gemcitabine-based therapy. We retrospectively evaluated the clinical outcomes of liposomal irinotecan (nal-IRI) plus fluorouracil/ leucovorin (FL) and FOLFIRINOX (fluorouracil, leucovorin, irinotecan, and oxaliplatin) in patients who had failed on the first-line gemcitabine-based therapy.
Patients and methods: From January 2015 to August 2019, 378 patients with MPC who had received nal-IRI/FL (n = 104) or FOLFIRINOX (n = 274) as second-line treatment across 11 institutions were included in this retrospective study.
Results: There were no significant differences in baseline characteristics between groups, except age and first-line regimens. With a median follow-up of 6 months, the median progression-free survival (PFS) was 3.7 months with nal-IRI/FL versus 4.6 months with FOLFIRINOX (P = 0.44). Median overall survival (OS) was 7.7 months with nal-IRI/ FL versus 9.7 months with FOLFRINOX (P = 0.13). There was no significant difference in PFS and OS between the two regimens in the univariate and multivariate analyses. The subgroup analysis revealed that younger age (<70 years) was associated with better OS with FOLFIRINOX. In contrast, older age (>= 70 years) was associated with better survival outcomes with nal-IRI/FL. Adverse events were manageable with both regimens; however, the incidence of grade 3 or higher neutropenia and peripheral neuropathy was higher in patients treated with FOLFIRINOX than with nal-IRI/FL.
Conclusions: Second-line nal-IRI/FL and FOLFIRINOX showed similar effectiveness outcomes after progression following first-line gemcitabine-based therapy. Age could be the determining factor for choosing the appropriate second-line therapy.
- Author(s)
- 강명주; 강버들; 강정훈; 김일환; 김정훈; 김진원; 김진원; 박준오; 박형순; 배우균; 유창훈; 이충근; 임현수; 전홍재; 천재경; 최혜진; 홍정용; 황준을; S. H. Lim
- Issued Date
- 2021
- Type
- Article
- Keyword
- FOLFIRINOX; liposomal irinotecan; Original Research; pancreatic cancer; second-line treatment
- DOI
- 10.1016/j.esmoop.2021.100049
- URI
- https://oak.ulsan.ac.kr/handle/2021.oak/7841
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7878976&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Liposomal%20irinotecan%20plus%20fluorouracil%2Fleucovorin%20versus%20FOLFIRINOX%20as%20the%20second-line%20chemotherapy%20for%20patients%20with%20metastatic%20pancreatic%20cancer:%20a%20multicenter%20retrospective%20study%20of%20the%20Korean%20Cancer%20Study%20Group%20(KCSG)&offset=0&pcAvailability=true
- Publisher
- ESMO OPEN
- Location
- 스위스
- Language
- 영어
- ISSN
- 2059-7029
- Citation Volume
- 6
- Citation Number
- 2
- Citation Start Page
- 0
- Citation End Page
- 0
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