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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)

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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)
강명주강버들강정훈김일환김정훈김진원김진원박준오박형순배우균유창훈이충근임현수전홍재천재경최혜진홍정용황준을S. H. Lim
Issued Date
2021
Type
Article
Keyword
FOLFIRINOXliposomal irinotecanOriginal Researchpancreatic cancersecond-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&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;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)&amp;offset=0&amp;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
Appears in Collections:
Medicine > Medicine
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