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Investigational New Drugs

, Volume 36, Issue 4, pp 732–741 | Cite as

Nab-paclitaxel plus gemcitabine versus FOLFIRINOX as the first-line chemotherapy for patients with metastatic pancreatic cancer: retrospective analysis

  • Jihoon Kang
  • Inhwan Hwang
  • Changhoon Yoo
  • Kyu-pyo Kim
  • Jae Ho Jeong
  • Heung-Moon Chang
  • Sang Soo Lee
  • Do Hyun Park
  • Tae Jun Song
  • Dong Wan Seo
  • Sung Koo Lee
  • Myung-Hwan Kim
  • Seung-Mo Hong
  • Sang Hyun Shin
  • Dae Wook Hwang
  • Ki Byung Song
  • Jae Hoon Lee
  • Song Cheol Kim
  • Baek-Yeol Ryoo
SHORT REPORT

Summary

Purpose nab-paclitaxel plus gemcitabine (AG) and FOLFIRINOX have been established as standard first-line treatment in metastatic pancreatic cancer (mPC). We performed retrospective analysis comparing the efficacies of AG and FOLFIRINOX in daily practice setting. Materials and Methods We analyzed 308 patients who presented initially as mPC and received AG (n = 149) or FOLFIRINOX (n = 159) as first-line treatment between 2013 and 2016. Primary endpoints were progression-free survival (PFS) and overall survival (OS). Result There were no significant differences between the two groups in terms of baseline characteristics, except older age and higher Charlson Comorbidity Index (CCI) score in AG group. The response rates (34% vs 34%) and median PFS (6.8 vs 5.1 months) were comparable between two groups (p = 0.88 and p = 0.19, respectively), while median OS was significantly better with AG than FOLFIRINOX (11.4 vs 9.6 months; p = 0.002). Elevated baseline CA19–9 level and liver metastasis were independent adverse prognostic factors for PFS and OS. In subgroup analyses, PFS with AG was better in patients with age ≥ 65 years, peritoneal metastasis, and higher CCI than that with FOLFIRINOX. Conclusion Both AG and FOLFIRINOX showed comparable efficacy outcomes in daily practice setting. AG might be preferentially considered in patients with peritoneal metastasis, comorbid medical conditions or old age.

Keywords

Pancreatic cancer Chemotherapy Metastatic nab-paclitaxel Gemcitabine FOLFIRINOX 

Notes

Funding

This study was supported by grants from the Asan Institute for Life Sciences, Asan Medical Center in Seoul, Korea (2017–728).

Compliance with ethical standards

Conflicts of interest

The authors have no conflicts of interest to declare.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of study, formal consent is not required.

Supplementary material

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Supplementary Figure S1

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High resolution image (TIFF 339 kb)
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Supplementary Table S1 (DOCX 17 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Jihoon Kang
    • 1
    • 2
  • Inhwan Hwang
    • 1
  • Changhoon Yoo
    • 1
  • Kyu-pyo Kim
    • 1
  • Jae Ho Jeong
    • 1
  • Heung-Moon Chang
    • 1
  • Sang Soo Lee
    • 3
  • Do Hyun Park
    • 3
  • Tae Jun Song
    • 3
  • Dong Wan Seo
    • 3
  • Sung Koo Lee
    • 3
  • Myung-Hwan Kim
    • 3
  • Seung-Mo Hong
    • 4
  • Sang Hyun Shin
    • 5
  • Dae Wook Hwang
    • 5
  • Ki Byung Song
    • 5
  • Jae Hoon Lee
    • 5
  • Song Cheol Kim
    • 5
  • Baek-Yeol Ryoo
    • 1
  1. 1.Department of Oncology, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
  2. 2.Division of Hematology/Oncology, Department of Internal Medicine, Kangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulSouth Korea
  3. 3.Department of Gastroenterology, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
  4. 4.Department of Pathology, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
  5. 5.Department of Surgery, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea

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