From the Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima.
Department of Hepato-biliary-pancreatic Medicine, Saga-ken Medical Center Koseikan, Saga.
Pancreas. 2021 Aug 1;50(7):957-964. doi: 10.1097/MPA.0000000000001859.
FOLFIRINOX (FFX, a combination of oxaliplatin, irinotecan, fluorouracil, and leucovorin) and gemcitabine plus nab-paclitaxel (GnP) have been used as standard, first-line treatments for advanced pancreatic cancer. However, no study has compared the efficacy of the 2 regimens. This study retrospectively compared the efficacy and safety of the 2 regimens in patients with locally advanced pancreatic cancer.
We reviewed the records of patients with locally advanced pancreatic cancer who started FFX or GnP as first-line chemotherapy as part of a multicenter retrospective study in patients with unresectable pancreatic cancer treated with FFX or GnP (NAPOLEON study).
Sixteen of the 63 patients were treated with FFX, and the other 47 patients were treated with GnP between December 2013 and March 2017. There were no significant differences in median overall survival rate between the GnP (15.5 months) and FFX (14.3 months, P = 0.60) groups or median progression-free survival rate between the GnP (8.8 months) and FFX (8.1 months, P = 0.51) groups. Both treatments were generally well tolerated, although anorexia was more severe in the FFX group than in the GnP group.
The effects of FFX and GnP were similar but resulted in different toxicities, which could guide agent choice.
FOLFIRINOX（FFX，奥沙利铂、伊立替康、氟尿嘧啶和亚叶酸钙的联合用药）和吉西他滨加 nab-紫杉醇（GnP）已被用作晚期胰腺癌的标准一线治疗药物。然而，尚无研究比较这两种方案的疗效。本研究回顾性比较了局部晚期胰腺癌患者使用这两种方案的疗效和安全性。
我们回顾了 2013 年 12 月至 2017 年 3 月间在无法切除的胰腺癌患者中接受 FFX 或 GnP 治疗的多中心回顾性研究中接受 FFX 或 GnP（NAPOLEON 研究）作为一线化疗的局部晚期胰腺癌患者的记录。
63 例患者中有 16 例接受 FFX 治疗，47 例接受 GnP 治疗。GnP（15.5 个月）和 FFX（14.3 个月，P=0.60）组中位总生存率、GnP（8.8 个月）和 FFX（8.1 个月，P=0.51）组中位无进展生存率均无显著差异。两种治疗方法均普遍耐受良好，尽管 FFX 组比 GnP 组更严重的食欲下降。
FFX 和 GnP 的疗效相似，但毒性不同，这可以指导药物选择。
