Impact of previous S-1 treatment on efficacy of liposomal irinotecan plus 5-fluorouracil and leucovorin in patients with metastatic pancreatic cancer.
Journal
Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]
Journal Volume
24
Journal Issue
4
Start Page
600
End Page
607
ISSN
1424-3911
Date Issued
2024-06
Author(s)
Tang, Cheng-Yu
Li, Chung-Pin
Su, Yung-Yeh
Chiu, Sz-Chi
Bai, Li-Yuan
Shan, Yan-Shen
Chen, Li-Tzong
Chuang, Shih-Chang
Chan, De-Chuan
Yen, Chia-Jui
Peng, Cheng-Ming
Chiu, Tai-Jan
Chen, Jen-Shi
Chiang, Nai-Jung
Chou, Wen-Chi
Abstract
Liposomal irinotecan plus 5-fluorouracil and leucovorin (nal-IRI + 5-FU/LV) provides survival benefits for metastatic pancreatic adenocarcinoma (mPDAC) refractory to gemcitabine-based treatment, mainly gemcitabine plus nab-paclitaxel (GA), in current practice. Gemcitabine plus S-1 (GS) is another commonly administered first-line regimen before nab-paclitaxel reimbursement; however, the efficacy and safety of nal-IRI + 5-FU/LV for mPDAC after failed GS treatment has not been reported and was therefore explored in this study.
In total, 177 patients with mPDAC received first-line GS or GA treatment, followed by second-line nal-IRI + 5-FU/LV treatment (identified from a multicenter retrospective cohort in Taiwan from 2018 to 2020); 85 and 92 patients were allocated to the GS and GA groups, respectively. Overall survival (OS), time-to-treatment failure (TTF), and adverse events were compared between the two groups.
The baseline characteristics of the two groups were generally similar; however, a higher median age (67 versus 62 years, p < 0.001) and fewer liver metastases (52% versus 78%, p < 0.001) were observed in the GS versus GA group. The median OS was 15.0 and 15.9 months in the GS and GA groups, respectively (p = 0.58). The TTF (3.1 versus 2.8 months, p = 0.36) and OS (7.6 versus 6.7 months, p = 0.83) after nal-IRI treatment were similar between the two groups. More patients in the GS group developed mucositis during nal-IRI treatment (15% versus 4%, p = 0.02).
The efficacy of second-line nal-IRI +5-FU/LV treatment was unaffected by prior S-1 exposure. GS followed by nal-IRI treatment is an alternative treatment sequence for patients with mPDAC.
Subjects
Gemcitabine
Nab-paclitaxel
Pancreatic adenocarcinoma
SDGs
Type
journal article