Comparison of FOLFIRINOX and gemcitabine plus nab-paclitaxel for treatment of metastatic pancreatic cancer: Using Korean Pancreatic Cancer (K-PaC) Registry

Jong Chan Lee, Sang Myung Woo, Dong Woo Shin, Jinkook Kim, Se Yeol Yang, Min Jae Kim, Jin Won Kim, Ji Won Kim, Woo Jin Lee, Hyo Soung Cha, Philiip Park, Jaihwan Kim, Jin Hyeok Hwang

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Abstract

Objective:By using the Korean Pancreatic Cancer (K-PaC) registry, we compared the clinical outcomes of FOLFIRINOX (FFX) and gemcitabine plus nab-paclitaxel (GNP) in patients with metastatic pancreatic cancer (MPC).Methods:We constructed a web-based database of 3748 anonymized patients diagnosed with pancreatic ductal adenocarcinoma. MPC patients who received first-line FFX or GNP were enrolled. Overall survival (OS), progression-free survival, grade III to IV toxicity, and cross-over treatment were analyzed.Results:A total of 413 patients (232 vs. 181, FFX vs. GNP; all data are presented in this sequence) were eligible. Median age was 63 years (60 vs. 69 y) with 43% (39% vs. 47%) comprising female individuals. The major metastatic sites were the liver (64%), peritoneum (25%), and distant lymph nodes (18%). The median OS was 11.5 versus 12.7 months (hazard ratio [HR]=0.87, 95% confidence interval [CI]: 0.68-1.12, P=0.286), and median progression-free survival was 7.5 versus 8.1 months (HR=0.92, 95% CI: 0.70-1.20, P=0.517), respectively. The frequency of grade III to IV febrile neutropenia was higher in the FFX group (18% vs. 11%, P=0.040), and that of peripheral neuropathy was higher in the GNP group (8% vs. 14%, P=0.046). The chance to receive second-line chemotherapy was higher in the GNP group (45% vs. 56%, P=0.036). In the cross-over treatment, the median OS of the FFX-GNP group (n=43) and the GNP-FFX group (n=47) was 16.8 versus 17.7 months (HR=0.79, 95% CI: 0.44-1.41, P=0.425).Conclusions:FFX and GNP showed similar efficacy and comparable toxicity in MPC patients. Although the GNP group had a higher chance to receive second-line chemotherapy, they did not have improved overall survival.

Original languageEnglish
Pages (from-to)654-659
Number of pages6
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume43
Issue number9
DOIs
StatePublished - 1 Sep 2020

Keywords

  • FOLFIRINOX
  • K-PaC registry
  • metastatic pancreatic cancer
  • nab-paclitaxel

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