Survival after neoadjuvant and induction FOLFIRINOX versus gemcitabine-nab-paclitaxel in patients with resected localised pancreatic adenocarcinoma: an international multicentre study.
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Stoop Thomas F, Wu Y H Andrew, Oba Atsushi, Ali Mahsoem, Feld Isabel M, Al-Musawi Mohammed H, Jain Ajay, Saiura Akio, Sauvanet Alain, Coppola Alessandro, Javed Ammar A, Groot Koerkamp Bas, Miller Braden N, Hashimoto Daisuke, Caputo Damiano, Kleive Dyre, Sereni Elisabetta, Kazemier Geert, Belfiori Giulio, Ishida Hirofumi, van Dam Jacob L, Dembinski Jeanne, Akahoshi Keiichi, Roberts Keith J, Tanaka Kimitaka, Labori Knut J, Falconi Massimo, House Michael G, Sugimoto Motokazu, Tanabe Minoru, Gotohda Naoto, Chatzizacharias Nikolaos, Krohn Paul S, Dokmak Safi, Rodriguez Franco Salvador, Hirano Satoshi, Burgdorf Stefan K, Crippa Stefano, Satoi Sohei, Nguyen Trang K, Yamamoto Tomohisa, Nakamura Toru, Ushida Yuta, Bachu Vismaya, Burns William R, Inoue Yosuke, Takahashi Yu, Aslami Zohra, Schulick Richard D, He Jin, Messersmith Wells, Besselink Marc G, Burkhart Richard A, Wilmink Johanna W, Del Chiaro Marco, International Consortium on Pancreatic Cancer Surgery and Oncology (ICON)
Аннотация
METHODS: International multicentre retrospective study (16 centres, 8 countries, 3 continents), including consecutive patients after pancreatic resection for localised pancreatic adenocarcinoma following 2-6 months preoperative (m)FOLFIRINOX or gemcitabine-nab-paclitaxel (2010-2018). Primary endpoint was OS from start of preoperative chemotherapy. Cox regression analysis was performed to investigate the association of the preoperative chemotherapy regimen with OS, adjusted for confounders at diagnosis.
RESULTS: Overall, 935 patients were included after resection of localised pancreatic adenocarcinoma following preoperative (m)FOLFIRINOX (65%) or gemcitabine-nab-paclitaxel (35%). Preoperative chemotherapy regimen (m)FOLFIRINOX was not associated with OS (HR = 0.83 [95% CI 0.64-1.08]), compared to gemcitabine-nab-paclitaxel. Interaction analysis showed stronger effect of (m)FOLFIRINOX in patients with a lower (i.e., non-elevated/marginally elevated) serum CA19-9 at diagnosis (pinteraction = 0.032).
CONCLUSION: This international study found no OS benefit of preoperative (m)FOLFIRINOX in patients with resected localised pancreatic adenocarcinoma compared to gemcitabine-nab-paclitaxel.