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- W4382806979 abstract "GEM/nab-PTX (GnP) or (modified) FOLFIRINOX [(m)FFX] is recommended as primary chemotherapy for metastatic pancreatic cancer, however second-line treatment is controversial. There is no clear consensus on the second-line treatment following progression on GnP for metastaic pancreatic cancer, especially with regard to the choice between (m) FFX and 5-FU/LV/nal-IRI (NAPOLI). Therefore, we retrospectively reviewed the clinical outcomes of second-line treatment of metastatic pancreatic cancer treated with GnP as primary therapy at our institution. From January 2015 to August 2021, 263 metastatic pancreatic cancer patients received GnP as primary treatment and were received second-line treatment at our institution. We analyzed the clinical outcomes of 107 patients who received mFFX and 40 patients who received NAPOLI as second-line treatment after GnP therapy. The results were shown in the order of mFFX group vs. NAPOLI group. In terms of background factors, only age [median 63 years (range 35-76) vs. 75 (38-80) p < 0.01] and the proportion of patients who did not respond to GnP (21.5% vs. 47.5% p < 0.01) were significantly different. There were no statistically significant differences in other factors including gender, body mass index, performance status, comorbidities, diabetes mellitus, histological diagnosis, number of metastatic organs, percentage of postoperative recurrence, biliary drainage, serum albumin level, and serum CA19-9 level at the initiation of second-line treatment. Median overall survival (OS) after initiation of second-line treatment was 7.2 (95% CI: 6.4-8.4) months vs. 7.9 (5.3-10.3) months p=0.98, progression-free survival (PFS) was 3.6 (2.8-5.1) months vs. 5.1 (2.7-6.5) months p=0.85, and the rate of grade 3 or higher adverse events was 29.9% vs. 20.0% p=0.30. Propensity score matching was performed including all of the aforementioned background ifactors, and comparisons of clinical outcomes were made with matched pair cohort, including 17 patients in each group. OS was 7.0 (4.0-14.2) months vs. 8.9 (2.8-NA) months p=0.73, PFS was 3.7 (2.2-12.2) months vs. 4.4 (1.3-6.7) months p=0.30, and the rate of grade 3 or higher adverse events was 29.4% vs. 23.5% p=1.0 in matched pair cohort. NAPOLI tended to be selected over mFFX for second-line treatment after GnP in older patients and in patients who did not respond to GnP. Howerver, there were also no statistically significant differences in clinical outcomes and adverse event rates in the matched pair cohort." @default.
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- W4382806979 date "2023-06-01" @default.
- W4382806979 modified "2023-09-24" @default.
- W4382806979 title "P-252 Comparison of second-line treatment after GEM/nab-PTX therapy for metastatic pancreatic cancer" @default.
- W4382806979 doi "https://doi.org/10.1016/j.annonc.2023.04.308" @default.
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