Impact of previous S-1 treatment on efficacy of liposomal irinotecan plus 5-fluorouracil and leucovorin in patients with metastatic pancreatic cancer,Pancreatology

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Impact of previous S-1 treatment on efficacy of liposomal irinotecan plus 5-fluorouracil and leucovorin in patients with metastatic pancreatic cancer
Pancreatology ( IF 3.6 ) Pub Date : 2024-03-25 , DOI: 10.1016/j.pan.2024.03.014
Cheng-Yu Tang , Shih-Hung Yang , Chung-Pin Li , Yung-Yeh Su , Sz-Chi Chiu , Li-Yuan Bai , Yan-Shen Shan , Li-Tzong Chen , Shih-Chang Chuang , De-Chuan Chan , Chia-Jui Yen , Cheng-Ming Peng , Tai-Jan Chiu , Yen-Yang Chen , Jen-Shi Chen , Nai-Jung Chiang , Wen-Chi Chou

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, < 0.001) and fewer liver metastases (52% versus 78%, < 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 ( = 0.58). The TTF (3.1 versus 2.8 months, = 0.36) and OS (7.6 versus 6.7 months, = 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%, = 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.

更新日期：2024-03-25

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