Cho In Rae, Kang Huapyong, Jo Jung Hyun, Lee Hee Seung, Chung Moon Jae, Park Jeong Youp, Park Seung Woo, Song Si Young, An Chansik, Park Mi-Suk, Bang Seungmin
Department of Internal Medicine, International Saint Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon 22711, South Korea.
Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seoul 03722, South Korea.
World J Gastrointest Oncol. 2020 Feb 15;12(2):182-194. doi: 10.4251/wjgo.v12.i2.182.
FOLFIRINOX and gemcitabine plus nab-paclitaxel (Gem + nabPTX) were recently introduced for metastatic pancreatic cancer treatment. However, studies that compared these two regimens and studies in Asian populations are lacking.
To compare the treatment outcomes of FOLFIRINOX and Gem + nabPTX regimen for metastatic pancreatic cancer treatment in Korean population.
Patients with metastatic or recurrent pancreatic cancer treated with FOLFIRINOX ( = 86) or Gem + nabPTX ( = 81) as the first-line since January 2015 were identified using the Severance Hospital Pancreatic Cancer Cohort Registry. Treatment efficacy, treatment-related adverse events and economic aspects were compared.
Patients in the FOLFIRINOX group were significantly younger (54 65 years; < 0.001) and had better performance statuses at diagnosis. The median overall survival (10.7 12.1 mo; = 0.157), progression-free survival (8.0 8.4 mo; = 0.134), and objective response rates (33.7% 46.9%; = 0.067) were not significantly different when compared with Gem + nabPTX group. Grade ≥ 3 neutropenia and gastrointestinal adverse events were more common in the FOLFIRINOX group. The drug costs of both regimens were similar.
Treatment efficacy and economic burdens were comparable between the two regimens. But, the details of adverse event were different. Gem + nabPTX regimen might be considered preferentially in certain conditions.
FOLFIRINOX方案以及吉西他滨联合白蛋白结合型紫杉醇（Gem + nabPTX）方案最近被用于转移性胰腺癌的治疗。然而，比较这两种方案的研究以及针对亚洲人群的研究尚属空白。
比较FOLFIRINOX方案和Gem + nabPTX方案在韩国人群中治疗转移性胰腺癌的疗效。
使用首尔延世大学Severance医院胰腺癌队列登记系统，确定自2015年1月以来接受FOLFIRINOX方案（n = 86）或Gem + nabPTX方案（n = 81）作为一线治疗的转移性或复发性胰腺癌患者。比较两种方案的治疗效果、治疗相关不良事件及经济方面的情况。
FOLFIRINOX组患者显著更年轻（54对65岁；P < 0.001），且诊断时体能状态更好。与Gem + nabPTX组相比，中位总生存期（10.7对12.1个月；P = 0.157）、无进展生存期（8.0对8.4个月；P = 0.134）和客观缓解率（33.7%对46.9%；P = 0.067）无显著差异。≥3级中性粒细胞减少和胃肠道不良事件在FOLFIRINOX组更为常见。两种方案的药物成本相似。
两种方案的治疗效果和经济负担相当。但是，不良事件的细节有所不同。在某些情况下，Gem + nabPTX方案可能更值得优先考虑。
