https://scholars.lib.ntu.edu.tw/handle/123456789/596677
Title: | Liposomal irinotecan pre-emptive dose reduction in patients with pancreatic ductal adenocarcinoma: 667 patients' experience within a population-based study | Authors: | Chiu T.-J. Su Y.-Y. SHIH-HUNG YANG Li C.-P. Bai L.-Y. Chiang N.-J. Chuang S.-C. Shan Y.-S. Chan D.-C. Chen L.-T. Yen C.-J. Peng C.-M. Chen Y.-Y. Chen J.-S. Chou W.-C. |
Keywords: | dose reduction; liposomal irinotecan; outcome; pancreatic cancer; toxicity | Issue Date: | 2021 | Publisher: | SAGE Publications Inc. | Journal Volume: | 13 | Source: | Therapeutic Advances in Medical Oncology | Abstract: | Background: Liposomal irinotecan (nal-IRI) plus 5-fluorouracil and leucovorin (5-FU/LV) is currently the standard second-line treatment for patients with pancreatic ductal adenocarcinoma (PDAC) after previous failed gemcitabine-based therapy. This population-based study aimed to evaluate the efficacy and safety of nal-IRI + 5-FU/LV and the association of pre-emptive nal-IRI dosing with treatment outcomes in patients with PDAC. Methods: We retrospectively enrolled a total of 667 consecutive patients with PDAC who received nal-IRI plus 5-FU/LV treatment between August 2018 and November 2020 at 9 medical centers in Taiwan. Patients were allocated into groups according to pre-emptive nal-IRI dosing (?75%, 50–74%, <50%) for comparison of treatment efficacy and safety. Results: The median overall survival (OS) and time to treatment failure (TTF) were 5.9 months [95% confidence interval (CI), 5.3–6.5] and 2.8 months (95% CI, 2.6–3.0), respectively. The median OS was 6.5 months (95% CI, 5.7–6.7), 5.0 months (95% CI, 3.4–6.5), and 4.1 months (95% CI, 2.7–5.6), respectively, among the ?75%, 50–74%, and <50% pre-emptive nal-IRI dosing groups, whereas the median TTF of the three groups was 3.0 months (95% CI, 2.6–3.4), 2.6 months (95% CI, 2.3–2.9), and 1.9 months (95% CI, 1.6–2.2), respectively. Pre-emptive nal-IRI dosing <50% was an independent negative prognostic factor for OS and TTF in multivariate analyses. The most common severe adverse events were neutropenia (22.9%), anemia (21.1%), and hypokalemia (15.4%). Patients in the <50% pre-emptive nal-IRI dosing group had a significantly lower incidence of neutropenia and non-neutropenic infection than those in the other groups. Conclusion: Our results support the use of nal-IRI + 5-FU/LV as standard clinical practice for treating patients with PDAC based on this large population-based study. Our findings encourage physicians to provide adequate doses of nal-IRI in order to achieve better outcomes without compromising safety profiles. ? The Author(s), 2021. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85119484724&doi=10.1177%2f17588359211058255&partnerID=40&md5=6f6404404ce0a9fee235a1cbdc952303 https://scholars.lib.ntu.edu.tw/handle/123456789/596677 |
ISSN: | 1758-8340 | DOI: | 10.1177/17588359211058255 | SDG/Keyword: | albumin; carbohydrate antigen; fluorouracil; folinic acid; gemcitabine; irinotecan; liposome; platinum; adult; aged; anemia; Article; clinical practice; cohort analysis; diarrhea; drug dose reduction; drug efficacy; drug safety; drug withdrawal; fatigue; febrile neutropenia; female; human; hypertransaminasemia; hypokalemia; major clinical study; male; metastasis; mucosa inflammation; neutropenia; neutrophil lymphocyte ratio; overall survival; pancreatic ductal carcinoma; retrospective study; Taiwan; thrombocytopenia; treatment outcome; vomiting [SDGs]SDG3 |
Appears in Collections: | 腫瘤醫學研究所 |
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