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World J Clin Oncol. Sep 24, 2021; 12(9): 787-799
Published online Sep 24, 2021. doi: 10.5306/wjco.v12.i9.787
Real-world evidence on first- and second-line palliative chemotherapy in advanced pancreatic cancer
Hakon Blomstrand, Atul Batra, Winson Y Cheung, Nils Oskar Elander
Hakon Blomstrand, Nils Oskar Elander, Department of Biomedical and Clinical Sciences, Linköping University, Linköping 58185, Sweden
Atul Batra, Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi 110029, India
Winson Y Cheung, Department of Oncology, University of Calgary, Calgary T2N 4N1, Canada
Author contributions: Blomstrand H, Cheung WY and Elander NO planned the study; Blomstrand H and Batra A performed the literature search; Blomstrand H, Batra A, Cheung WY and Elander NO assessed and interpreted the search results, and all were major contributors to the manuscript; all authors read and approved the final manuscript.
Conflict-of-interest statement: The authors declare that they do not have any conflicting interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nils Oskar Elander, MD, PhD, Doctor, Department of Biomedical and Clinical Sciences, Linköping University, Linköping 58185, Sweden. nils.elander@liu.se
Received: February 28, 2021
Peer-review started: February 28, 2021
First decision: April 27, 2021
Revised: May 9, 2021
Accepted: August 12, 2021
Article in press: August 12, 2021
Published online: September 24, 2021
Processing time: 200 Days and 22.9 Hours
Core Tip

Core Tip: This review summarizes and interprets published real-world evidence of the effectiveness and safety of treatment strategies in advanced pancreatic cancer. The real-world outcomes of first-line chemotherapy regimens such as folfirinox and gemcitabine/ nab-paclitaxel are thoroughly reviewed. The results of randomized controlled trials (RCTs) exploring the regimens seem to be largely generalizable in a real-world context. On second-line options, i.e. salvage chemotherapy following failure of first-line therapy, significant uncertainties remain. Additional RCTs and real-world evidence studies addressing current and novel regimens, and the optimal sequence of these, are needed.