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Kieler, Markus; Unseld, Matthias; Bianconi, Daniela; Scheithauer, Werner; Prager, Gerald W.

Efficacy of liposomal-irinotecan (nal-IRI) plus 5-fluorouracil/folinic acid (5-FU/LV) versus oxaliplatin plus fluoropyrimidines in previous gemcitabine treated pancreatic adenocarcinoma (PAC) patients (pts)

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  • Media type: E-Article
  • Title: Efficacy of liposomal-irinotecan (nal-IRI) plus 5-fluorouracil/folinic acid (5-FU/LV) versus oxaliplatin plus fluoropyrimidines in previous gemcitabine treated pancreatic adenocarcinoma (PAC) patients (pts)
  • Contributor: Kieler, Markus; Unseld, Matthias; Bianconi, Daniela; Scheithauer, Werner; Prager, Gerald W.
  • imprint: American Society of Clinical Oncology (ASCO), 2019
  • Published in: Journal of Clinical Oncology
  • Language: English
  • DOI: 10.1200/jco.2019.37.4_suppl.383
  • ISSN: 0732-183X; 1527-7755
  • Keywords: Cancer Research ; Oncology
  • Origination:
  • Footnote:
  • Description: <jats:p> 383 </jats:p><jats:p> Background: The chemotherapy regimens nal-IRI plus 5-FU/LV as well as oxaliplatin plus fluoropyrimidines are used after previous gemcitabine based chemotherapy in the 2<jats:sup>nd</jats:sup> line treatment of metastatic PAC. We aimed to compare the clinical efficacy of these two treatment options. Methods: In this single institutional retrospective cohort analysis all pts with advanced PAC that were treated between 01/2012-08/2018 with nal-IRI plus 5-FU/LV or oxaliplatin plus fluoropyrimidines after previous 1<jats:sup>st</jats:sup> line gemcitabine based chemotherapy were analysed for clinical parameters, median progression free survival (mPFS) and overall survival (mOS). Survival analyses were performed by Kaplan-Meier method. Results: Characteristics of pts were well matched (Table). mPFS in pts (n=30) that received nal-IRI plus 5-FU/LV in the 2<jats:sup>nd</jats:sup> line treatment after gemcitabine based chemotherapy was 4.49 months while treatment with oxaliplatin plus fluoropyrimidines (n=31) resulted in a mPFS of 3.44 months (p=0.007, HR 0.47, 95% CI 0.27-0.81). Furthermore, pts with a CA 19-9 level &gt;1000 kU/l at the beginning of 2<jats:sup>nd</jats:sup> line treatment had a significantly improved mPFS and mOS, when treated with nal-IRI plus 5-FU/LV compared to oxaliplatin plus fluoropyrimidines (mPFS 4.94 months versus 3.44 months, p=0.0186, HR 0.42, 95% CI 0.18-0.98; mOS 9.31 months versus 6.16 months, p=0.0386, HR 0.43, 95% CI 0.18-1.02). Conclusions: The efficacy of nal-IRI plus 5-FU/LV in our study is encouraging and outperforms oxaliplatin-based chemotherapy in the 2<jats:sup>nd</jats:sup> line treatment setting for PAC pts pretreated with gemcitabine. Prospective randomized trials are urged to validate our observation. [Table: see text] </jats:p>
  • Access State: Open Access