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 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: n = 60; FFX: n = 87) were included. Tumor resection rates were similar between the two groups (16.7% vs. 16.1%; p = 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; p = 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; p = 0.7), respectively. Abdominal pain at the baseline (HR = 2.03, p = 0.03), tumors located in the tail of the pancreas (HR = 4.35, p = 0.01), CA19-9 > 200 UI/L (HR = 2.03, p = 0.004) and tumor resection (HR = 0.37, p = 0.007) were independent prognostic factors for PFS, similarly to OS. CA19-9 ≤ 200 UI/L (OR = 2.6, p = 0.047) was predictive of the tumor response. Consolidation chemoradiotherapy, more often used in the FFX group (11.7% vs. 50.6%; p < 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.
['Williet|Nicolas|N|', 'Petrillo|Angelica|A|0000-0001-5489-5733', 'Roth|Gaël|G|0000-0001-5822-4320', 'Ghidini|Michele|M|0000-0001-5435-1218', 'Petrova|Mila|M|', 'Forestier|Julien|J|', 'Lopez|Anthony|A|', 'Thoor|Audrey|A|', 'Weislinger|Lucie|L|', 'De Vita|Ferdinando|F|', 'Taieb|Julien|J|0000-0002-9955-4753', 'Phelip|Jean Marc|JM|']
gemcitabine/nab-paclitaxel FOLFIRINOX pancreatic cancer prognostic factors predictors of response