Kieler Markus, Unseld Matthias, Bianconi Daniela, Scheithauer Werner, Prager Gerald W
Department of Medicine I, Division of Oncology, Comprehensive Cancer Center, Medical University Vienna, Austria.
Department of Medicine I, Division of Oncology, Comprehensive Cancer Center, Medical University Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
Ther Adv Med Oncol. 2019 Jul 17;11:1758835919853196. doi: 10.1177/1758835919853196. eCollection 2019.
Nanoliposomal irinotecan (nal-IRI) plus 5-fluorouracil/leucovorin (5-FU/LV) is a novel treatment option for gemcitabine-pretreated metastatic pancreatic adenocarcinoma (PAC) patients, but real-world evidence is rare. Our aim was to determine the effectiveness and tolerability of this regimen in advanced PAC patients and to compare it with oxaliplatin plus fluoropyrimidines in the second-line setting after failure of gemcitabine.
This is a retrospective single-center analysis of all patients who have been treated with nal-IRI plus 5-FU/LV. To compare its effectiveness with other second-line treatment options, all patients who had received oxaliplatin plus fluoropyrimidines after gemcitabine-based chemotherapy were also eligible for analysis.
Fifty-two patients were treated with nal-IRI plus 5-FU/LV between April 2016 and August 2018. The median progression-free survival (PFS) was 3.84 months and the median overall survival (OS) was 6.79 months. Median OS from the beginning of the treatment for advanced disease was 19.9 months. Median PFS in patients that received nal-IRI plus 5-FU/LV as second-line treatment after gemcitabine-based chemotherapy was 4.49 months whereas median PFS in a matched cohort of patients treated with oxaliplatin plus fluoropyrimidines was 3.44 months ( = 0.007). Between these two groups the median OS of patients with CA 19-9 levels above the statistical median (⩾772.8 kU/l) differed significantly (9.33 6.18 months, = 0.038).
Our data confirms the effectiveness of nal-IRI plus 5-FU/LV treatment as a well-tolerated regimen in the treatment of advanced PAC and extends available data on its use as a second-line treatment option when compared with oxaliplatin plus fluoropyrimidines.
纳米脂质体伊立替康（nal-IRI）联合5-氟尿嘧啶/亚叶酸钙（5-FU/LV）是吉西他滨预处理的转移性胰腺腺癌（PAC）患者的一种新型治疗选择，但真实世界证据较少。我们的目的是确定该方案在晚期PAC患者中的有效性和耐受性，并在吉西他滨治疗失败后的二线治疗中，将其与奥沙利铂联合氟嘧啶进行比较。
这是一项对所有接受nal-IRI联合5-FU/LV治疗患者的回顾性单中心分析。为了将其有效性与其他二线治疗方案进行比较，所有在基于吉西他滨的化疗后接受奥沙利铂联合氟嘧啶治疗的患者也符合分析条件。
2016年4月至2018年8月期间，52例患者接受了nal-IRI联合5-FU/LV治疗。中位无进展生存期（PFS）为3.84个月，中位总生存期（OS）为6.79个月。晚期疾病治疗开始后的中位OS为19.9个月。在基于吉西他滨的化疗后接受nal-IRI联合5-FU/LV作为二线治疗的患者中，中位PFS为4.49个月，而在接受奥沙利铂联合氟嘧啶治疗的匹配队列患者中，中位PFS为3.44个月（P = 0.007）。在这两组中，CA 19-9水平高于统计学中位数（≥772.8 kU/l）的患者的中位OS有显著差异（9.33对6.18个月，P = 0.038）。
我们的数据证实了nal-IRI联合5-FU/LV治疗作为一种耐受性良好的方案在晚期PAC治疗中的有效性，并扩展了其与奥沙利铂联合氟嘧啶相比作为二线治疗选择的可用数据。
