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)

ESMO Open

article

H.S. Park¹  B. Kang²  H.J. Chon²  H.-S. Im³  C.-K. Lee⁴  I. Kim⁵  M.J. Kang⁵  J.E. Hwang⁶  W.K. Bae⁶  J. Cheon⁷  J.O. Park⁸  J.Y. Hong⁸  J.H. Kang⁹  J.H. Kim⁹  S.H. Lim^1,10  J.W. Kim^1,11  J.-W. Kim^1,11  C. Yoo³  H.J. Choi⁴ 

[1] Division of Medical Oncology, Department of Internal Medicine, St. Vincent"s Hospital, The Catholic University of Korea;Medical Oncology, CHA Bundang Medical Center, CHA University;Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine;Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine;Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine;Division of Hematology-Oncology, Department of Internal Medicine, Chonnam National University Medical School and Hwasun Hospital;Department of Hematology and Oncology, Ulsan University Hospital, Ulsan University College of Medicine;Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University College of Medicine;Department of Internal Medicine, Gyeongsang National University School of Medicine;Division of Hematology-Oncology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital;Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine

关键词: pancreatic cancer;    second-line treatment;    liposomal irinotecan;    FOLFIRINOX;   

DOI  :  10.1016/j.esmoop.2021.100049

学科分类：社会科学、人文和艺术（综合）

来源: BMJ Publishing Group

【 摘 要 】

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.

【 授权许可】

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