Shiho Arima1, Machiko Kawahira1, Mototsugu Shimokawa, Akio Ido1, Futa Koga2, Yujiro Ueda3, Junichi Nakazawa4, Azusa Komori5, Satoshi Otsu5, Masaru Fukahori6, Akitaka Makiyama, Hiroki Taguchi, Takuya Honda7, Taro Shibuki, Kenji Mitsugi8, Kenta Nio9, Yasushi Ide10, Norio Ureshino, Toshihiko Mizuta, Tsuyoshi Shirakawa, Taiga Otsuka. 1. From the Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima. 2. Department of Hepato-biliary-pancreatic Medicine, Saga-ken Medical Center Koseikan, Saga. 3. Department of Hematology and Oncology, Japanese Red Cross Kumamoto Hospital, Kumamoto. 4. Department of Gastroenterology and Hepatology, Kagoshima City Hospital, Kagoshima. 5. Department of Medical Oncology and Hematology, Oita University Faculty of Medicine, Oita. 6. Department of Medicine, Division of Gastroenterology, Kurume University Hospital. 7. Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki. 8. Department of Medical Oncology, Hamanomachi Hospital, Fukuoka. 9. Department of Medical Oncology, Sasebo Kyosai Hospital, Nagasaki. 10. Department of Internal Medicine, Karatsu Red Cross Hospital.
Abstract
OBJECTIVES: FOLFIRINOX (FFX, a combination of oxaliplatin, irinotecan, fluorouracil, and leucovorin) and gemcitabine plus nab-paclitaxel (GnP) have been used as standard, first-line treatments for advanced pancreatic cancer. However, no study has compared the efficacy of the 2 regimens. This study retrospectively compared the efficacy and safety of the 2 regimens in patients with locally advanced pancreatic cancer. METHODS: We reviewed the records of patients with locally advanced pancreatic cancer who started FFX or GnP as first-line chemotherapy as part of a multicenter retrospective study in patients with unresectable pancreatic cancer treated with FFX or GnP (NAPOLEON study). RESULTS: Sixteen of the 63 patients were treated with FFX, and the other 47 patients were treated with GnP between December 2013 and March 2017. There were no significant differences in median overall survival rate between the GnP (15.5 months) and FFX (14.3 months, P = 0.60) groups or median progression-free survival rate between the GnP (8.8 months) and FFX (8.1 months, P = 0.51) groups. Both treatments were generally well tolerated, although anorexia was more severe in the FFX group than in the GnP group. CONCLUSIONS: The effects of FFX and GnP were similar but resulted in different toxicities, which could guide agent choice.
OBJECTIVES: FOLFIRINOX (FFX, a combination of oxaliplatin, irinotecan, fluorouracil, and leucovorin) and gemcitabine plus nab-paclitaxel (GnP) have been used as standard, first-line treatments for advanced pancreatic cancer. However, no study has compared the efficacy of the 2 regimens. This study retrospectively compared the efficacy and safety of the 2 regimens in patients with locally advanced pancreatic cancer. METHODS: We reviewed the records of patients with locally advanced pancreatic cancer who started FFX or GnP as first-line chemotherapy as part of a multicenter retrospective study in patients with unresectable pancreatic cancer treated with FFX or GnP (NAPOLEON study). RESULTS: Sixteen of the 63 patients were treated with FFX, and the other 47 patients were treated with GnP between December 2013 and March 2017. There were no significant differences in median overall survival rate between the GnP (15.5 months) and FFX (14.3 months, P = 0.60) groups or median progression-free survival rate between the GnP (8.8 months) and FFX (8.1 months, P = 0.51) groups. Both treatments were generally well tolerated, although anorexia was more severe in the FFX group than in the GnP group. CONCLUSIONS: The effects of FFX and GnP were similar but resulted in different toxicities, which could guide agent choice.