Han SY, Kim DU, Seol YM, Kim S, Lee NK, Hong SB, Seo HI. Comparison of gemcitabine plus nab-paclitaxel and FOLFIRINOX in metastatic pancreatic cancer. World J Clin Cases 2020; 8(17): 3718-3729 [PMID: 32953848 DOI: 10.12998/wjcc.v8.i17.3718]
Corresponding Author of This Article
Dong Uk Kim, MD, PhD, Assistant Professor, Department of Internal Medicine and Biomedical Research Institute, Division of Gastroenterology, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan 49241, South Korea. amlm3@hanmail.net
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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/
World J Clin Cases. Sep 6, 2020; 8(17): 3718-3729 Published online Sep 6, 2020. doi: 10.12998/wjcc.v8.i17.3718
Comparison of gemcitabine plus nab-paclitaxel and FOLFIRINOX in metastatic pancreatic cancer
Sung Yong Han, Dong Uk Kim, Young Mi Seol, Suk Kim, Nam Kyung Lee, Seung Baek Hong, Hyung-Il Seo
Sung Yong Han, Dong Uk Kim, Department of Internal Medicine and Biomedical Research Institute, Division of Gastroenterology, Pusan National University Hospital, Busan 49241, South Korea
Young Mi Seol, Department of Hematology-Oncology, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
Suk Kim, Nam Kyung Lee, Seung Baek Hong, Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
Hyung-Il Seo, Department of Surgery, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
Author contributions: Kim DU and Seo HI contributed to the conceptualization; Han SY contributed to writing original draft; Han SY, Kim DU, and Seol YM contributed to writing review and editing; Han SY and Kim S contributed to data acquisition and analysis; Lee NK and Hong SB contributed to the investigation; Kim DU and Seol YM contributed to the supervision.
Supported bythe National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT), No. NRF-2018R1C1B5086234.
Institutional review board statement: The study protocol was approved by the Institutional Review Board of Pusan National University, IRB No. H-2002-023-088.
Informed consent statement: Written informed consent was waived.
Conflict-of-interest statement: The authors declare no conflict of interest.
Data sharing statement: No additional data are available.
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: Dong Uk Kim, MD, PhD, Assistant Professor, Department of Internal Medicine and Biomedical Research Institute, Division of Gastroenterology, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan 49241, South Korea. amlm3@hanmail.net
Received: June 18, 2020 Peer-review started: June 18, 2020 First decision: July 24, 2020 Revised: July 28, 2020 Accepted: August 13, 2020 Article in press: August 13, 2020 Published online: September 6, 2020 Processing time: 78 Days and 1.8 Hours
Abstract
BACKGROUND
Gemcitabine plus nab-paclitaxel (GA) and modified FOLFIRINOX (FFX) have been widely used as standard first-line treatment in pancreatic cancer. However, it is unclear which regimen is more efficacious.
AIM
To evaluate a retrospective analysis comparing the efficacy and safety of FFX and GA as first-line chemotherapeutic regimens in patients with metastatic pancreatic cancer.
METHODS
We retrospectively analyzed and compared outcomes in 101 patients who presented with pancreatic cancer and were treated with either GA (n = 54) or FFX (n = 47). Moreover, we performed subgroup analysis based on the neutrophil/lymphocyte ratio (NLR) and Eastern Cooperative Oncology Group (ECOG) performance status.
RESULTS
There were no significant differences between two groups in baseline characteristics, except for the ECOG performance status. The median progression-free survival (PFS) (6.43 mo vs 4.90 mo, P = 0.058) was comparable between two groups; however, median overall survival (OS) (10.17 mo vs 6.93 mo, P = 0.008) was longer in patients who received GA regimen. In patients with ECOG 0 (PFS: 8.93 mo vs 5.43 mo, P = 0.002; OS: 16.10 mo vs 6.97 mo, P = 0.000) and those with NLR < 3 (PFS: 8.10 mo vs 6.57 mo, P = 0.008; OS: 12.87 mo vs 9.93 mo, P = 0.002), GA regimen showed higher efficacy.
CONCLUSION
GA regimen may be recommended to the patients with NLR < 3 or ECOG 0 status although GA and FFX showed comparable efficacy outcomes in patients with metastatic pancreatic cancer.
Core tip: Gemcitabine plus nab-paclitaxel (GA) and modified FOLFIRINOX (FFX) have been widely used as standard first-line treatment in pancreatic cancer. However, it is unclear which regimen is more efficacious. Our retrospective study aims to explore the efficacy and safety of FFX and GA as first-line chemotherapeutic regimens in patients with metastatic pancreatic cancer. Our data showed that comparable result in both regimens. However, GA regimen have better result of median progression free survival and overall survival in patients with ECOG 0 status or neutrophil/lymphocyte ratio < 3.
