Second-line and third-line therapy with nanoliposomal irinotecan (nal-IRI) in pancreatic cancera single-center experience and review of literature
Second-line and third-line therapy with nanoliposomal irinotecan (nal-IRI) in pancreatic cancer
a single-center experience and review of literature
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https://hdl.handle.net/20.500.11811/10815
Abstract
Background: Prognosis of patients with pancreatic cancer is still extremely poor. First-line palliative therapies with FOLFIRINOX or gemcitabine/nab-paclitaxel have been established in the last decade. In the second-line, 5-FU/LV in combination with nanoliposomal irinotecan (nal-IRI) after gemcitabine has been shown to be effective. However, the use of nal-IRI as third-line therapy after FOLFIRINOX and gemcitabine-based chemotherapies is still controversial. In this study, we report about the use of 5-FU/LV + nal-IRI in a daily practice and analyze whether nal-IRI is an option as third-line therapy after FOLFIRINOX and gemcitabine/nab-paclitaxel.
Methods: This is a single center retrospective analysis of patients with irresectable pancreatic cancer who were treated with 5-FU/LV and nal-IRI from 2017 to 2021 as second- or third-line palliative treatment. Overall survival (OS), progression-free survival (PFS) and toxicity were analyzed, and multivariate analysis was used to identify independent prognostic factors.
Results: Twenty-nine patients receiving 5-FU/LV and nal-IRI were included in the analysis. The majority of patients (n=19) received 5-FU/nal-IRI as third-line therapy after pre-exposition to FOLFIRINOX and gemcitabine/nab-paclitaxel. Median OS and PFS were 9.33 months (95% CI: 3.37, 15.30) and 2.90 months (95% CI: 1.64, 4.16), respectively. Furthermore, patients receiving nal-IRI + 5-FU/LV as third-line treatment also showed some benefits, with no OS difference compared to second-line patients (9.33 vs. 10.27 months; HR: 1.85; 95% CI: 0.64, 5.41; P=0.253). Adverse effects were similar to reported trials.
Conclusions: In our study, the use of 5-FU/nal-IRI in unselected patients with advanced pancreatic cancer showed similar OS, PFS and tolerance as randomized prospective phase II/III trials. Interestingly, the use of 5-FU/nal-IRI seemed to be beneficial in third-line therapy, despite a pre-exposure to non-liposomal irinotecan.
Subjects
FOLFIRINOX, irinotecan resistance, nal-irinotecan, palliative chemotherapy, pancreatic cancer
Classification (DDC)
610 Medizin, GesundheitPublished in
Journal of Gastrointestinal Oncology, 2023, vol. 14, 1, pp. 352-365First Publication
https://doi.org/10.21037/jgo-22-632Möhring, Christian; Frontado Graffe, Freddy José; Bartels, Alexandra; Sadeghlar, Farsaneh; Zhou, Taotao; Mahn, Robert; Marinova, Milka; Feldmann, Georg; Brossart, Peter; Glowka, Tim; Kalff, Jörg; Strassburg, Christian; Gonzalez-Carmona, Maria: Second-line and third-line therapy with nanoliposomal irinotecan (nal-IRI) in pancreatic cancer : a single-center experience and review of literature. In: Journal of Gastrointestinal Oncology. 2023, vol. 14, 1, 352-365.
Online-Ausgabe in bonndoc: https://hdl.handle.net/20.500.11811/10815
Online-Ausgabe in bonndoc: https://hdl.handle.net/20.500.11811/10815
@article{handle:20.500.11811/10815,
author = {{Christian Möhring} and {Freddy José Frontado Graffe} and {Alexandra Bartels} and {Farsaneh Sadeghlar} and {Taotao Zhou} and {Robert Mahn} and {Milka Marinova} and {Georg Feldmann} and {Peter Brossart} and {Tim Glowka} and {Jörg Kalff} and {Christian Strassburg} and {Maria Gonzalez-Carmona}},
title = {Second-line and third-line therapy with nanoliposomal irinotecan (nal-IRI) in pancreatic cancer : a single-center experience and review of literature},
publisher = {AME Publishing Company},
year = 2023,
month = feb,
journal = {Journal of Gastrointestinal Oncology},
volume = 2023, vol. 14,
number = 1,
pages = 352--365,
note = {Background: Prognosis of patients with pancreatic cancer is still extremely poor. First-line palliative therapies with FOLFIRINOX or gemcitabine/nab-paclitaxel have been established in the last decade. In the second-line, 5-FU/LV in combination with nanoliposomal irinotecan (nal-IRI) after gemcitabine has been shown to be effective. However, the use of nal-IRI as third-line therapy after FOLFIRINOX and gemcitabine-based chemotherapies is still controversial. In this study, we report about the use of 5-FU/LV + nal-IRI in a daily practice and analyze whether nal-IRI is an option as third-line therapy after FOLFIRINOX and gemcitabine/nab-paclitaxel. Methods: This is a single center retrospective analysis of patients with irresectable pancreatic cancer who were treated with 5-FU/LV and nal-IRI from 2017 to 2021 as second- or third-line palliative treatment. Overall survival (OS), progression-free survival (PFS) and toxicity were analyzed, and multivariate analysis was used to identify independent prognostic factors. Results: Twenty-nine patients receiving 5-FU/LV and nal-IRI were included in the analysis. The majority of patients (n=19) received 5-FU/nal-IRI as third-line therapy after pre-exposition to FOLFIRINOX and gemcitabine/nab-paclitaxel. Median OS and PFS were 9.33 months (95% CI: 3.37, 15.30) and 2.90 months (95% CI: 1.64, 4.16), respectively. Furthermore, patients receiving nal-IRI + 5-FU/LV as third-line treatment also showed some benefits, with no OS difference compared to second-line patients (9.33 vs. 10.27 months; HR: 1.85; 95% CI: 0.64, 5.41; P=0.253). Adverse effects were similar to reported trials. Conclusions: In our study, the use of 5-FU/nal-IRI in unselected patients with advanced pancreatic cancer showed similar OS, PFS and tolerance as randomized prospective phase II/III trials. Interestingly, the use of 5-FU/nal-IRI seemed to be beneficial in third-line therapy, despite a pre-exposure to non-liposomal irinotecan.},
url = {https://hdl.handle.net/20.500.11811/10815}
}
author = {{Christian Möhring} and {Freddy José Frontado Graffe} and {Alexandra Bartels} and {Farsaneh Sadeghlar} and {Taotao Zhou} and {Robert Mahn} and {Milka Marinova} and {Georg Feldmann} and {Peter Brossart} and {Tim Glowka} and {Jörg Kalff} and {Christian Strassburg} and {Maria Gonzalez-Carmona}},
title = {Second-line and third-line therapy with nanoliposomal irinotecan (nal-IRI) in pancreatic cancer : a single-center experience and review of literature},
publisher = {AME Publishing Company},
year = 2023,
month = feb,
journal = {Journal of Gastrointestinal Oncology},
volume = 2023, vol. 14,
number = 1,
pages = 352--365,
note = {Background: Prognosis of patients with pancreatic cancer is still extremely poor. First-line palliative therapies with FOLFIRINOX or gemcitabine/nab-paclitaxel have been established in the last decade. In the second-line, 5-FU/LV in combination with nanoliposomal irinotecan (nal-IRI) after gemcitabine has been shown to be effective. However, the use of nal-IRI as third-line therapy after FOLFIRINOX and gemcitabine-based chemotherapies is still controversial. In this study, we report about the use of 5-FU/LV + nal-IRI in a daily practice and analyze whether nal-IRI is an option as third-line therapy after FOLFIRINOX and gemcitabine/nab-paclitaxel. Methods: This is a single center retrospective analysis of patients with irresectable pancreatic cancer who were treated with 5-FU/LV and nal-IRI from 2017 to 2021 as second- or third-line palliative treatment. Overall survival (OS), progression-free survival (PFS) and toxicity were analyzed, and multivariate analysis was used to identify independent prognostic factors. Results: Twenty-nine patients receiving 5-FU/LV and nal-IRI were included in the analysis. The majority of patients (n=19) received 5-FU/nal-IRI as third-line therapy after pre-exposition to FOLFIRINOX and gemcitabine/nab-paclitaxel. Median OS and PFS were 9.33 months (95% CI: 3.37, 15.30) and 2.90 months (95% CI: 1.64, 4.16), respectively. Furthermore, patients receiving nal-IRI + 5-FU/LV as third-line treatment also showed some benefits, with no OS difference compared to second-line patients (9.33 vs. 10.27 months; HR: 1.85; 95% CI: 0.64, 5.41; P=0.253). Adverse effects were similar to reported trials. Conclusions: In our study, the use of 5-FU/nal-IRI in unselected patients with advanced pancreatic cancer showed similar OS, PFS and tolerance as randomized prospective phase II/III trials. Interestingly, the use of 5-FU/nal-IRI seemed to be beneficial in third-line therapy, despite a pre-exposure to non-liposomal irinotecan.},
url = {https://hdl.handle.net/20.500.11811/10815}
}
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