KEY TAKEAWAYS
- The study aimed to compare 2L treatment outcomes for pts with unresectable PC post-GnP therapy.
- The key study outcome was to evaluate the OS and PFS.
- Researchers noticed that NFF showed better OS than S-1, influenced by patient-specific factors.
Pancreatic cancer (PC) ranks as the 7 leading cause of cancer-related mortality globally. As per the current scenario, surgical resection is the only option for PC. However, only 15% of patients (pts) are eligible for a potentially curative pancreatectomy due to the prevalence of distant metastases or locoregional spread, including vascular invasion, at the time of diagnosis. Consequently, systemic chemotherapy is a critical component in managing pts with unresectable PC.
Taro Shibuki and the team aimed to compare second-line (2L) treatment outcomes for pts with unresectable PC previously treated with gemcitabine plus nab-paclitaxel (GnP) therapy.
They conducted an integrated analysis of 2 retrospective studies included 318 pts receiving nanoliposomal irinotecan + 5-fluorouracil/folinic acid (NFF) (n = 102), S-1 (n = 57), or FOLFIRINOX (n = 14) as 2L treatment.
Results indicated that the 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, which was not statistically different from NFF.
Subgroup analyses revealed that NFF generally demonstrated superior OS, though a significant interaction was observed between the treatment regimen and serum albumin levels < 3.5 g/dL (P= 0.042) and serum CRP levels ≥ 0.3 mg/dL (P= 0.006).
The median progression-free survival (PFS) for NFF was 2.93 months, significantly better than S-1, which had a PFS of 2.53 months (P= 0.024). FOLFIRINOX showed comparable PFS at 3.04 months (P= 0.948). Multivariate analysis identified serum CRP, serum CA19-9 levels, duration of first-line (1L) GnP therapy, and the use of S-1 for 2L treatments as independent predictors of OS.
The study concluded that the 2L NFF therapy demonstrated a relatively significant OS vs S-1 therapy, subject to the patient’s background while selecting the most appropriate course of treatment.
Funding information was not provided for this study.
Source: https://pubmed.ncbi.nlm.nih.gov/39043707/
Shibuki T, Otsuka T, Shimokawa M, et al. (2024). “Nanoliposomal irinotecan with fluorouracil and folinic acid, FOLFIRINOX, and S-1 as second-line treatment for unresectable pancreatic cancer after gemcitabine/nab-paclitaxel. Sci Rep. 2024 Jul 23;14(1):16906. doi: 10.1038/s41598-024-65689-8. PMID: 39043707; PMCID: PMC11266600.
