Equivalent Efficacy but Different Safety Profiles of Gemcitabine Plus Nab-Paclitaxel and FOLFIRINOX in Metastatic Pancreatic Cancer
FOLFIRINOX (FFX) and gemcitabine + nab-paclitaxel (GN) are the most common chemotherapy regimens in first-line treatment of metastatic pancreatic cancer (PC). They have not been compared each other in a prospective trial, but only in retrospective studies, which can thus be affected by several biase...
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MDPI AG
2021-05-01
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| Series: | Biomolecules |
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| Online Access: | https://www.mdpi.com/2218-273X/11/6/780 |
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| author | Ilario Giovanni Rapposelli Andrea Casadei-Gardini Caterina Vivaldi Giulia Bartolini Laura Bernardini Alessandro Passardi Giovanni Luca Frassineti Valentina Massa Alessandro Cucchetti |
| author_facet | Ilario Giovanni Rapposelli Andrea Casadei-Gardini Caterina Vivaldi Giulia Bartolini Laura Bernardini Alessandro Passardi Giovanni Luca Frassineti Valentina Massa Alessandro Cucchetti |
| author_sort | Ilario Giovanni Rapposelli |
| collection | DOAJ |
| description | FOLFIRINOX (FFX) and gemcitabine + nab-paclitaxel (GN) are the most common chemotherapy regimens in first-line treatment of metastatic pancreatic cancer (PC). They have not been compared each other in a prospective trial, but only in retrospective studies, which can thus be affected by several biases. In order to overcome these biases, we took advantage of matching-adjusted indirect comparison (MAIC), that allows an indirect comparison by reducing cross-trial differences, and compared data from 268 patients treated with GN in a real-world setting with data from the 171 patients included in the FFX arm of the PRODIGE trial. Survival outcomes did not differ between the two populations. Overall survival was 11.1 months for both treatments (hazard ratio (HR) of FFX 1.10, 95% confidence interval (CI) 0.81–1.49; <i>p</i> = 0.527). Progression-free survival was 6.0 months with GN and 6.4 months with FFX (HR of FFX 1.11, 95% CI 0.82–1.50; <i>p</i> = 0.520). On the other hand, we observed a difference in the toxicity profiles: grade 3/4 anemia was more frequent with GN, whereas a higher occurrence of grade 3/4 vomiting and diarrhea was reported with FFX. FFX and GN show an equivalent efficacy but different safety profiles in the first-line therapy of metastatic pancreatic cancer. Searching for reliable predictive biomarkers is advised in order to improve therapeutic strategy in metastatic PC. |
| first_indexed | 2024-03-10T11:08:56Z |
| format | Article |
| id | doaj.art-02eb3a24f42942e2a95d9d12bde585fc |
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| issn | 2218-273X |
| language | English |
| last_indexed | 2024-03-10T11:08:56Z |
| publishDate | 2021-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomolecules |
| spelling | doaj.art-02eb3a24f42942e2a95d9d12bde585fc2023-11-21T20:54:13ZengMDPI AGBiomolecules2218-273X2021-05-0111678010.3390/biom11060780Equivalent Efficacy but Different Safety Profiles of Gemcitabine Plus Nab-Paclitaxel and FOLFIRINOX in Metastatic Pancreatic CancerIlario Giovanni Rapposelli0Andrea Casadei-Gardini1Caterina Vivaldi2Giulia Bartolini3Laura Bernardini4Alessandro Passardi5Giovanni Luca Frassineti6Valentina Massa7Alessandro Cucchetti8Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori “Dino Amadori”-IRST, 47014 Meldola, ItalyUnit of Oncology, IRCCS San Raffaele Scientific Institute, 20132 Milan, ItalyDepartment of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, ItalyDepartment of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori “Dino Amadori”-IRST, 47014 Meldola, ItalyUnit of Medical Oncology, Azienda Ospedaliero-Universitaria Pisana, 56126 Pisa, ItalyDepartment of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori “Dino Amadori”-IRST, 47014 Meldola, ItalyDepartment of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori “Dino Amadori”-IRST, 47014 Meldola, ItalyUnit of Medical Oncology, Azienda Ospedaliero-Universitaria Pisana, 56126 Pisa, ItalyDepartment of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-University of Bologna, 40126 Bologna, ItalyFOLFIRINOX (FFX) and gemcitabine + nab-paclitaxel (GN) are the most common chemotherapy regimens in first-line treatment of metastatic pancreatic cancer (PC). They have not been compared each other in a prospective trial, but only in retrospective studies, which can thus be affected by several biases. In order to overcome these biases, we took advantage of matching-adjusted indirect comparison (MAIC), that allows an indirect comparison by reducing cross-trial differences, and compared data from 268 patients treated with GN in a real-world setting with data from the 171 patients included in the FFX arm of the PRODIGE trial. Survival outcomes did not differ between the two populations. Overall survival was 11.1 months for both treatments (hazard ratio (HR) of FFX 1.10, 95% confidence interval (CI) 0.81–1.49; <i>p</i> = 0.527). Progression-free survival was 6.0 months with GN and 6.4 months with FFX (HR of FFX 1.11, 95% CI 0.82–1.50; <i>p</i> = 0.520). On the other hand, we observed a difference in the toxicity profiles: grade 3/4 anemia was more frequent with GN, whereas a higher occurrence of grade 3/4 vomiting and diarrhea was reported with FFX. FFX and GN show an equivalent efficacy but different safety profiles in the first-line therapy of metastatic pancreatic cancer. Searching for reliable predictive biomarkers is advised in order to improve therapeutic strategy in metastatic PC.https://www.mdpi.com/2218-273X/11/6/780metastatic pancreatic cancerfirst-line therapymatching-adjusted indirect comparison |
| spellingShingle | Ilario Giovanni Rapposelli Andrea Casadei-Gardini Caterina Vivaldi Giulia Bartolini Laura Bernardini Alessandro Passardi Giovanni Luca Frassineti Valentina Massa Alessandro Cucchetti Equivalent Efficacy but Different Safety Profiles of Gemcitabine Plus Nab-Paclitaxel and FOLFIRINOX in Metastatic Pancreatic Cancer Biomolecules metastatic pancreatic cancer first-line therapy matching-adjusted indirect comparison |
| title | Equivalent Efficacy but Different Safety Profiles of Gemcitabine Plus Nab-Paclitaxel and FOLFIRINOX in Metastatic Pancreatic Cancer |
| title_full | Equivalent Efficacy but Different Safety Profiles of Gemcitabine Plus Nab-Paclitaxel and FOLFIRINOX in Metastatic Pancreatic Cancer |
| title_fullStr | Equivalent Efficacy but Different Safety Profiles of Gemcitabine Plus Nab-Paclitaxel and FOLFIRINOX in Metastatic Pancreatic Cancer |
| title_full_unstemmed | Equivalent Efficacy but Different Safety Profiles of Gemcitabine Plus Nab-Paclitaxel and FOLFIRINOX in Metastatic Pancreatic Cancer |
| title_short | Equivalent Efficacy but Different Safety Profiles of Gemcitabine Plus Nab-Paclitaxel and FOLFIRINOX in Metastatic Pancreatic Cancer |
| title_sort | equivalent efficacy but different safety profiles of gemcitabine plus nab paclitaxel and folfirinox in metastatic pancreatic cancer |
| topic | metastatic pancreatic cancer first-line therapy matching-adjusted indirect comparison |
| url | https://www.mdpi.com/2218-273X/11/6/780 |
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