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)
- Authors
- Park, HS[Park, H. S.]; Kang, B[Kang, B.]; Chon, HJ[Chon, H. J.]; Im, HS[Im, H-S]; Lee, CK[Lee, C-K]; Kim, I[Kim, I]; Kang, MJ[Kang, M. J.]; Hwang, JE[Hwang, J. E.]; Bae, WK[Bae, W. K.]; Cheon, J[Cheon, J.]; Park, JO[Park, J. O.]; Hong, JY[Hong, J. Y.]; Kang, JH[Kang, J. H.]; Kim, JH[Kim, J. H.]; Lim, SH[Lim, S. H.]; Kim, JW[Kim, J. W.]; Kim, JW[Kim, J-W]; Yoo, C[Yoo, C.]; Choi, HJ[Choi, H. J.]
- Issue Date
- Apr-2021
- Publisher
- ELSEVIER
- Keywords
- pancreatic cancer; second-line treatment; liposomal irinotecan; FOLFIRINOX
- Citation
- ESMO OPEN, v.6, no.2
- Indexed
- SCIE
SCOPUS
- Journal Title
- ESMO OPEN
- Volume
- 6
- Number
- 2
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/1251
- DOI
- 10.1016/j.esmoop.2021.100049
- ISSN
- 2059-7029
- 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.
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