FOLFIRINOX vs. Gemcitabine Nab-Paclitaxel in Pancreatic Cancer: A Real-World Single-Center Analysis of Efficacy and Safety.

IF 1.6 Q4 ONCOLOGY

Journal of Gastrointestinal Cancer Pub Date : 2025-08-16 DOI:10.1007/s12029-025-01287-9

Arif Mohammed Khan, Vamshi Krishna Muddu, Naga Avinash Bonda, Indraja Siripurapu, Rimsha Ahmed, Safa Takreem, Syeda Sana Shahnoor, Sobia Noor, Sannapaneni Krishnaiah, G V Rao, D Nageshwar Reddy

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引用次数: 0

Abstract

Background: Pancreatic cancer is among the most lethal malignancies, with limited real-world data comparing frontline chemotherapy regimens across disease stages. FOLFIRINOX and gemcitabine plus nab-paclitaxel (G + P) are standard treatments with differing toxicity profiles and outcomes. This study evaluated the comparative efficacy and safety of these regimens in metastatic, locally advanced (LAPC), and borderline resectable pancreatic cancer (BRPC).

Methods: We conducted a retrospective study of 150 patients treated between October 2019 and November 2023 at a tertiary center in India. Patients received FOLFIRINOX (n = 64) or G + P (n = 86) as first-line therapy. Subgroup sizes included metastatic (n = 89), LAPC (n = 34), and BRPC (n = 27). Outcomes assessed included progression-free survival (PFS), overall survival (OS), event-free survival (EFS), response rates, resectability, and toxicities. Kaplan-Meier analysis and Cox regression were used. Subgroup analyses were stratified by stage and CA 19-9 levels.

Results: In metastatic disease, median OS was 11 months (FOLFIRINOX) vs. 10 months (G + P; HR = 1.26, p = 0.38); PFS was 6 months in both groups. In LAPC, OS was 15.5 vs. 17 months (p = 0.84). In BRPC, FOLFIRINOX showed superior OS (37 vs. 16 months; p = 0.02) and higher surgical conversion (66% vs. 39%). Grade ≥ 3 toxicities occurred in 45% (FOLFIRINOX) vs. 21% (G + P). Elevated CA 19-9 (> 37 U/mL) independently predicted worse OS (HR = 1.72; p = 0.029).

Conclusion: FOLFIRINOX and G + P have comparable efficacy in metastatic and locally advanced pancreatic cancer. FOLFIRINOX offers a survival benefit in BRPC but with higher toxicity.

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FOLFIRINOX与吉西他滨nab -紫杉醇治疗胰腺癌：一项真实世界单中心疗效和安全性分析

背景：胰腺癌是最致命的恶性肿瘤之一，比较不同疾病阶段一线化疗方案的实际数据有限。FOLFIRINOX和吉西他滨+ nab-紫杉醇（G + P）是具有不同毒性和结果的标准治疗。本研究评估了这些方案在转移性、局部晚期（LAPC）和交界性可切除胰腺癌（BRPC）中的相对疗效和安全性。方法：我们对2019年10月至2023年11月在印度一家三级医疗中心接受治疗的150名患者进行了回顾性研究。患者接受FOLFIRINOX （n = 64）或G + P （n = 86）作为一线治疗。亚组大小包括转移性（n = 89）、LAPC （n = 34）和BRPC （n = 27）。评估的结果包括无进展生存期（PFS）、总生存期（OS）、无事件生存期（EFS）、缓解率、可切除性和毒性。采用Kaplan-Meier分析和Cox回归分析。亚组分析按分期和ca19 -9水平分层。结果：在转移性疾病中，中位生存期为11个月（FOLFIRINOX） vs. 10个月(G + P；HR = 1.26, p = 0.38)；两组患者PFS均为6个月。在LAPC中，OS为15.5 vs. 17个月（p = 0.84）。在BRPC中，FOLFIRINOX表现出更好的OS(37个月vs. 16个月；P = 0.02)和更高的手术转换率（66%对39%）。45% （FOLFIRINOX）对21% （G + P）发生≥3级毒性。CA 19-9升高（> 37 U/mL）独立预测较差的OS (HR = 1.72；p = 0.029)。结论：FOLFIRINOX和G + P治疗转移性和局部晚期胰腺癌的疗效相当。FOLFIRINOX可提高BRPC患者的生存期，但毒性较高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Gastrointestinal Cancer ONCOLOGY-

CiteScore

3.80

自引率

0.00%

发文量

121

期刊介绍： The Journal of Gastrointestinal Cancer is a multidisciplinary medium for the publication of novel research pertaining to cancers arising from the gastrointestinal tract.The journal is dedicated to the most rapid publication possible.The journal publishes papers in all relevant fields, emphasizing those studies that are helpful in understanding and treating cancers affecting the esophagus, stomach, liver, gallbladder and biliary tree, pancreas, small bowel, large bowel, rectum, and anus. In addition, the Journal of Gastrointestinal Cancer publishes basic and translational scientific information from studies providing insight into the etiology and progression of cancers affecting these organs. New insights are provided from diverse areas of research such as studies exploring pre-neoplastic states, risk factors, epidemiology, genetics, preclinical therapeutics, surgery, radiation therapy, novel medical therapeutics, clinical trials, and outcome studies.In addition to reports of original clinical and experimental studies, the journal also publishes: case reports, state-of-the-art reviews on topics of immediate interest or importance; invited articles analyzing particular areas of pancreatic research and knowledge; perspectives in which critical evaluation and conflicting opinions about current topics may be expressed; meeting highlights that summarize important points presented at recent meetings; abstracts of symposia and conferences; book reviews; hypotheses; Letters to the Editors; and other items of special interest, including:Complex Cases in GI Oncology: This is a new initiative to provide a forum to review and discuss the history and management of complex and involved gastrointestinal oncology cases. The format will be similar to a teaching case conference where a case vignette is presented and is followed by a series of questions and discussion points. A brief reference list supporting the points made in discussion would be expected.