Article ; Online: Clinical Outcomes of S-1 Monotherapy and Modified FOLFIRINOX Therapy after Gemcitabine plus Nab-paclitaxel Therapy in Unresectable Pancreatic Cancer.
Internal medicine (Tokyo, Japan)
2022 Volume 61, Issue 15, Page(s) 2255–2261
Abstract: Objective S-1 and modified FOLFIRINOX (mFFX) were often used as the second-line chemotherapies after failure of gemcitabine plus nab-paclitaxel (GnP) in unresectable pancreatic cancer (UPC) until nanoliposomal irinotecan plus 5-fluorouracil/leucovorin ... ...
| Abstract | Objective S-1 and modified FOLFIRINOX (mFFX) were often used as the second-line chemotherapies after failure of gemcitabine plus nab-paclitaxel (GnP) in unresectable pancreatic cancer (UPC) until nanoliposomal irinotecan plus 5-fluorouracil/leucovorin therapy was approved as an alternative in Japan in 2020. However, the clinical outcomes of S-1 and mFFX after GnP have scarcely been reported. Therefore, we retrospectively studied them. Methods We extracted the clinical data of 86 patients with UPC who received second-line chemotherapy after GnP between 2015 and 2020. Among the patients who had a good organ functions and no massive ascites, 41 patients treated with S-1 and 21 treated with mFFX were enrolled. Results Compared to S-1, mFFX tended to be used for younger patients with a good general condition (median age, 63 vs. 71 years, p<0.01; and performance status 0, 67% vs. 37%, p<0.05). The median progression-free and overall survival were similar between the S-1 (3.7 and 7.2 months, respectively) and mFFX (3.3 and 7.4 months, respectively) groups. The response rate in patients with measurable lesions was 4% (n=1/23) in the S-1 group and 17% (n=2/12) in the mFFX group. The incidence of grade 3 or 4 adverse events was 20% in the S-1 group and 57% (neutrophil count decreased in 43%) in the mFFX group (p<0.01). Conclusion S-1 and mFFX were both acceptable second-line chemotherapies after GnP therapy for UPC, although attention should be paid to myelosuppression during mFFX treatment. Further studies involving nanoliposomal irinotecan plus 5-fluorouracil/leucovorin therapy are necessary to facilitate the selection of the optimal regimen for each patient. |
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| MeSH term(s) | Albumins/adverse effects ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Deoxycytidine/analogs & derivatives ; Fluorouracil ; Humans ; Irinotecan/adverse effects ; Leucovorin/adverse effects ; Middle Aged ; Oxaliplatin ; Paclitaxel/therapeutic use ; Pancreatic Neoplasms/pathology ; Retrospective Studies ; Gemcitabine ; Pancreatic Neoplasms | |||||
| Chemical Substances | 130-nm albumin-bound paclitaxel ; Albumins ; folfirinox ; Oxaliplatin (04ZR38536J) ; Deoxycytidine (0W860991D6) ; Irinotecan (7673326042) ; Paclitaxel (P88XT4IS4D) ; Leucovorin (Q573I9DVLP) ; Fluorouracil (U3P01618RT) ; Gemcitabine | |||||
| Language | English | |||||
| Publishing date | 2022-08-01 | |||||
| Publishing country | Japan | |||||
| Document type | Journal Article | |||||
| ZDB-ID | 32371-8 | |||||
| ISSN | 1349-7235 ; 0021-5120 ; 0918-2918 | |||||
| ISSN (online) | 1349-7235 | |||||
| ISSN | 0021-5120 ; 0918-2918 | |||||
| DOI | 10.2169/internalmedicine.8736-21 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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