Gemcitabine/Nab-Paclitaxel versus FOLFIRINOX in Locally Advanced Pancreatic Cancer: A European Multicenter Study
Background: Gemcitabine/nab-paclitaxel (GN) and FOLFIRINOX (FFX) are two standard first-line therapies for metastatic pancreatic cancer (PC) but have rarely been compared, especially in patients with locally advanced PC (LAPC). Methods: This is a retrospective European multicenter study including pa...
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MDPI AG
2021-06-01
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| Online Access: | https://www.mdpi.com/2072-6694/13/11/2797 |
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| author | Nicolas Williet Angelica Petrillo Gaël Roth Michele Ghidini Mila Petrova Julien Forestier Anthony Lopez Audrey Thoor Lucie Weislinger Ferdinando De Vita Julien Taieb Jean Marc Phelip |
| author_facet | Nicolas Williet Angelica Petrillo Gaël Roth Michele Ghidini Mila Petrova Julien Forestier Anthony Lopez Audrey Thoor Lucie Weislinger Ferdinando De Vita Julien Taieb Jean Marc Phelip |
| author_sort | Nicolas Williet |
| collection | DOAJ |
| description | Background: Gemcitabine/nab-paclitaxel (GN) and FOLFIRINOX (FFX) are two standard first-line therapies for metastatic pancreatic cancer (PC) but have rarely been compared, especially in patients with locally advanced PC (LAPC). Methods: This is a retrospective European multicenter study including patients with LAPC treated with either GN or FFX as the first-line therapy between 2010 and 2019. Coprimary objectives were progression-free survival (PFS) and overall survival (OS), both estimated using the Kaplan–Meier method. Results: A total of 147 patients (GN: <i>n</i> = 60; FFX: <i>n</i> = 87) were included. Tumor resection rates were similar between the two groups (16.7% vs. 16.1%; <i>p</i> = 1), with similar R0 resection rates (88.9%). Median PFS rates were not statistically different: 9 months (95% CI: 8–13.5) vs. 12.1 months (95% CI: 10.1–14.6; <i>p</i> = 0.8), respectively. Median OS rates were 15.7 months (95% CI: 12.6–20.2) and 16.7 months (95% CI: 14.8–20.4; <i>p</i> = 0.7), respectively. Abdominal pain at the baseline (HR = 2.03, <i>p</i> = 0.03), tumors located in the tail of the pancreas (HR = 4.35, <i>p</i> = 0.01), CA19-9 > 200 UI/L (HR = 2.03, <i>p</i> = 0.004) and tumor resection (HR = 0.37, <i>p</i> = 0.007) were independent prognostic factors for PFS, similarly to OS. CA19-9 ≤ 200 UI/L (OR = 2.6, <i>p</i> = 0.047) was predictive of the tumor response. Consolidation chemoradiotherapy, more often used in the FFX group (11.7% vs. 50.6%; <i>p</i> < 0.001), was not predictive. Conclusion: This retrospective study did not show any difference between GN and FFX as the first-line treatment in patients with LAPC. |
| first_indexed | 2024-03-10T10:42:50Z |
| format | Article |
| id | doaj.art-4dcb159d60094391b06f479e0cbed9b9 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T10:42:50Z |
| publishDate | 2021-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-4dcb159d60094391b06f479e0cbed9b92023-11-21T22:47:00ZengMDPI AGCancers2072-66942021-06-011311279710.3390/cancers13112797Gemcitabine/Nab-Paclitaxel versus FOLFIRINOX in Locally Advanced Pancreatic Cancer: A European Multicenter StudyNicolas Williet0Angelica Petrillo1Gaël Roth2Michele Ghidini3Mila Petrova4Julien Forestier5Anthony Lopez6Audrey Thoor7Lucie Weislinger8Ferdinando De Vita9Julien Taieb10Jean Marc Phelip11Department of Hepatogastroenterology, University Hospital of Saint-Etienne, 42000 Saint-Etienne, FranceDepartment of Precision Medecine, University of Study of Campania «L. Vanvitelli», 81100 Naples, ItalyHepato-Gastroenterology Department, University Hospital of Grenoble, 38043 Grenoble, FranceDepartment of Medical Oncology, Cancer Center, Hospital of Cremona, 26100 Cremona, ItalyDepartment of Medical Oncology, MHAT Nadezhda, 1220 Sofia, BulgariaDepartment of Medical Oncology, Hôpital Edouard Herriot, 69622 Lyon, FranceHepato-Gastroenterology Department, University Hospital of Nancy, 54500 Vandoeuvre-lès-Nancy, FranceHepato-Gastroenterology Department, University Hospital of Grenoble, 38043 Grenoble, FranceHepato-Gastroenterology Department, University Hospital of Nancy, 54500 Vandoeuvre-lès-Nancy, FranceDepartment of Precision Medecine, University of Study of Campania «L. Vanvitelli», 81100 Naples, ItalyDepartment of Gastroenterology and Gastro-Intestinal Oncology, Hôpital Européen Georges-Pompidou, APHP, Paris Descartes University, Sorbonne Paris Cité, 75004 Paris, FranceDepartment of Hepatogastroenterology, University Hospital of Saint-Etienne, 42000 Saint-Etienne, FranceBackground: Gemcitabine/nab-paclitaxel (GN) and FOLFIRINOX (FFX) are two standard first-line therapies for metastatic pancreatic cancer (PC) but have rarely been compared, especially in patients with locally advanced PC (LAPC). Methods: This is a retrospective European multicenter study including patients with LAPC treated with either GN or FFX as the first-line therapy between 2010 and 2019. Coprimary objectives were progression-free survival (PFS) and overall survival (OS), both estimated using the Kaplan–Meier method. Results: A total of 147 patients (GN: <i>n</i> = 60; FFX: <i>n</i> = 87) were included. Tumor resection rates were similar between the two groups (16.7% vs. 16.1%; <i>p</i> = 1), with similar R0 resection rates (88.9%). Median PFS rates were not statistically different: 9 months (95% CI: 8–13.5) vs. 12.1 months (95% CI: 10.1–14.6; <i>p</i> = 0.8), respectively. Median OS rates were 15.7 months (95% CI: 12.6–20.2) and 16.7 months (95% CI: 14.8–20.4; <i>p</i> = 0.7), respectively. Abdominal pain at the baseline (HR = 2.03, <i>p</i> = 0.03), tumors located in the tail of the pancreas (HR = 4.35, <i>p</i> = 0.01), CA19-9 > 200 UI/L (HR = 2.03, <i>p</i> = 0.004) and tumor resection (HR = 0.37, <i>p</i> = 0.007) were independent prognostic factors for PFS, similarly to OS. CA19-9 ≤ 200 UI/L (OR = 2.6, <i>p</i> = 0.047) was predictive of the tumor response. Consolidation chemoradiotherapy, more often used in the FFX group (11.7% vs. 50.6%; <i>p</i> < 0.001), was not predictive. Conclusion: This retrospective study did not show any difference between GN and FFX as the first-line treatment in patients with LAPC.https://www.mdpi.com/2072-6694/13/11/2797pancreatic cancerFOLFIRINOXgemcitabine/nab-paclitaxelprognostic factorspredictors of response |
| spellingShingle | Nicolas Williet Angelica Petrillo Gaël Roth Michele Ghidini Mila Petrova Julien Forestier Anthony Lopez Audrey Thoor Lucie Weislinger Ferdinando De Vita Julien Taieb Jean Marc Phelip Gemcitabine/Nab-Paclitaxel versus FOLFIRINOX in Locally Advanced Pancreatic Cancer: A European Multicenter Study Cancers pancreatic cancer FOLFIRINOX gemcitabine/nab-paclitaxel prognostic factors predictors of response |
| title | Gemcitabine/Nab-Paclitaxel versus FOLFIRINOX in Locally Advanced Pancreatic Cancer: A European Multicenter Study |
| title_full | Gemcitabine/Nab-Paclitaxel versus FOLFIRINOX in Locally Advanced Pancreatic Cancer: A European Multicenter Study |
| title_fullStr | Gemcitabine/Nab-Paclitaxel versus FOLFIRINOX in Locally Advanced Pancreatic Cancer: A European Multicenter Study |
| title_full_unstemmed | Gemcitabine/Nab-Paclitaxel versus FOLFIRINOX in Locally Advanced Pancreatic Cancer: A European Multicenter Study |
| title_short | Gemcitabine/Nab-Paclitaxel versus FOLFIRINOX in Locally Advanced Pancreatic Cancer: A European Multicenter Study |
| title_sort | gemcitabine nab paclitaxel versus folfirinox in locally advanced pancreatic cancer a european multicenter study |
| topic | pancreatic cancer FOLFIRINOX gemcitabine/nab-paclitaxel prognostic factors predictors of response |
| url | https://www.mdpi.com/2072-6694/13/11/2797 |
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