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Article

Gemcitabine/Nab-Paclitaxel versus FOLFIRINOX in Locally Advanced Pancreatic Cancer: A European Multicenter Study

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Department of Hepatogastroenterology, University Hospital of Saint-Etienne, 42000 Saint-Etienne, France
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Department of Precision Medecine, University of Study of Campania «L. Vanvitelli», 81100 Naples, Italy
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Hepato-Gastroenterology Department, University Hospital of Grenoble, 38043 Grenoble, France
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Department of Medical Oncology, Cancer Center, Hospital of Cremona, 26100 Cremona, Italy
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Department of Medical Oncology, MHAT Nadezhda, 1220 Sofia, Bulgaria
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Department of Medical Oncology, Hôpital Edouard Herriot, 69622 Lyon, France
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Hepato-Gastroenterology Department, University Hospital of Nancy, 54500 Vandoeuvre-lès-Nancy, France
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Department of Gastroenterology and Gastro-Intestinal Oncology, Hôpital Européen Georges-Pompidou, APHP, Paris Descartes University, Sorbonne Paris Cité, 75004 Paris, France
*
Author to whom correspondence should be addressed.
Academic Editor: Casper H. J. van Eijck
Cancers 2021, 13(11), 2797; https://doi.org/10.3390/cancers13112797
Received: 1 March 2021 / Revised: 1 June 2021 / Accepted: 3 June 2021 / Published: 4 June 2021
(This article belongs to the Special Issue Combination and Innovative Therapies for Pancreatic Cancer)
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). By carefully selecting patients, it is likely these two regimens lead to similar survival outcomes. Through a multicenter European study, biases regarding practice habits are reduced. Hence, we observed no difference between GN and FFX as first-line treatments in patients with LAPC in terms of either survival, tumor response or tumor resection rate. Further trials are needed to confirm these data.
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. View Full-Text
Keywords: pancreatic cancer; FOLFIRINOX; gemcitabine/nab-paclitaxel; prognostic factors; predictors of response pancreatic cancer; FOLFIRINOX; gemcitabine/nab-paclitaxel; prognostic factors; predictors of response
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MDPI and ACS Style

Williet, N.; Petrillo, A.; Roth, G.; Ghidini, M.; Petrova, M.; Forestier, J.; Lopez, A.; Thoor, A.; Weislinger, L.; De Vita, F.; Taieb, J.; Phelip, J.M. Gemcitabine/Nab-Paclitaxel versus FOLFIRINOX in Locally Advanced Pancreatic Cancer: A European Multicenter Study. Cancers 2021, 13, 2797. https://doi.org/10.3390/cancers13112797

AMA Style

Williet N, Petrillo A, Roth G, Ghidini M, Petrova M, Forestier J, Lopez A, Thoor A, Weislinger L, De Vita F, Taieb J, Phelip JM. Gemcitabine/Nab-Paclitaxel versus FOLFIRINOX in Locally Advanced Pancreatic Cancer: A European Multicenter Study. Cancers. 2021; 13(11):2797. https://doi.org/10.3390/cancers13112797

Chicago/Turabian Style

Williet, Nicolas, Angelica Petrillo, Gaël Roth, Michele Ghidini, Mila Petrova, Julien Forestier, Anthony Lopez, Audrey Thoor, Lucie Weislinger, Ferdinando De Vita, Julien Taieb, and Jean M. Phelip. 2021. "Gemcitabine/Nab-Paclitaxel versus FOLFIRINOX in Locally Advanced Pancreatic Cancer: A European Multicenter Study" Cancers 13, no. 11: 2797. https://doi.org/10.3390/cancers13112797

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