Frontiers in oncology · 2025
Efficacy of third-line chemotherapy following nanoliposomal irinotecan combined with fluorouracil and folinic acid as second-line treatment for unresectable pancreatic cancer.
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Miwa Keisuke, Kawasaki Reina, Shimokawa Mototsugu, Otsuka Taiga, Tanaka Toshimitsu, Fukahori Masaru, Shibuki Taro, Nakazawa Junichi, Arima Shiho, Koga Futa, Ueda Yujiro, Kubotsu Yoshihito, Shimokawa Hozumi, Takeshita Shigeyuki, Nishikawa Kazuo, Komori Azusa, Otsu Satoshi, Hosokawa Ayumu, Sakai Tatsunori, Oda Hisanobu, Kawahira Machiko, Arita Shuji, Honda Takuya, Taguchi Hiroki, Tsuneyoshi Kengo, Fujita Toshihiro, Sakae Takahiro, Kawaguchi Yasunori, Shirakawa Tsuyoshi, Mizuta Toshihiko, Mitsugi Kenji
Аннотация
INTRODUCTION: The significance of third-line chemotherapy (CTx) in unresectable pancreatic cancer (UPC) remains unclear. This study evaluated the therapeutic impact of third-line CTx after nanoliposomal irinotecan and fluorouracil combined with folinic acid (nal-IRI + 5-FU/LV) therapy as second-line CTx for UPC.
METHODS: Between June 2020 and May 2021, 104 patients who received nal-IRI + 5-FU/LV therapy as second-line CTx were retrospectively analyzed for post-discontinuation survival (PDS) and overall survival (OS). Comparisons were made between patients transitioning to third-line CTx and those receiving best supportive care (BSC), using a Cox proportional hazards model adjusted for patient background.
RESULTS: Of the cohort, 34 patients received third-line CTx, whereas 61 transitioned to BSC. The median OS from first-line CTx in the third-line CTx group was 18.0 months, with a median OS of 9.7 months from second-line CTx. Adjusted median PDS following second-line CTx was 6.5 months for the third-line CTx group compared to 2.3 months for the BSC group (adjusted hazard ratio 0.16; 95% confidence interval 0.08-0.32; P < 0.01).
CONCLUSION: Third-line CTx should be actively considered for patients with UPC, as the approach may significantly extend survival in those who can tolerate the treatment.
METHODS: Between June 2020 and May 2021, 104 patients who received nal-IRI + 5-FU/LV therapy as second-line CTx were retrospectively analyzed for post-discontinuation survival (PDS) and overall survival (OS). Comparisons were made between patients transitioning to third-line CTx and those receiving best supportive care (BSC), using a Cox proportional hazards model adjusted for patient background.
RESULTS: Of the cohort, 34 patients received third-line CTx, whereas 61 transitioned to BSC. The median OS from first-line CTx in the third-line CTx group was 18.0 months, with a median OS of 9.7 months from second-line CTx. Adjusted median PDS following second-line CTx was 6.5 months for the third-line CTx group compared to 2.3 months for the BSC group (adjusted hazard ratio 0.16; 95% confidence interval 0.08-0.32; P < 0.01).
CONCLUSION: Third-line CTx should be actively considered for patients with UPC, as the approach may significantly extend survival in those who can tolerate the treatment.