Stoop Thomas F, Wu Y H Andrew, Oba Atsushi, Ali Mahsoem, Feld Isabel M, Al-Musawi Mohammed H, Jain Ajay, Saiura Akio, Sauvanet Alain, Coppola Alessandro, Javed Ammar A, Groot Koerkamp Bas, Miller Braden N, Hashimoto Daisuke, Caputo Damiano, Kleive Dyre, Sereni Elisabetta, Kazemier Geert, Belfiori Giulio, Ishida Hirofumi, van Dam Jacob L, Dembinski Jeanne, Akahoshi Keiichi, Roberts Keith J, Tanaka Kimitaka, Labori Knut J, Falconi Massimo, House Michael G, Sugimoto Motokazu, Tanabe Minoru, Gotohda Naoto, Chatzizacharias Nikolaos, Krohn Paul S, Dokmak Safi, Rodriguez Franco Salvador, Hirano Satoshi, Burgdorf Stefan K, Crippa Stefano, Satoi Sohei, Nguyen Trang K, Yamamoto Tomohisa, Nakamura Toru, Ushida Yuta, Bachu Vismaya, Burns William R, Inoue Yosuke, Takahashi Yu, Aslami Zohra, Schulick Richard D, He Jin, Messersmith Wells, Besselink Marc G, Burkhart Richard A, Wilmink Johanna W, Del Chiaro Marco
Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA.
Amsterdam UMC, Location University of Amsterdam, Department of Surgery, Amsterdam, The Netherlands.
Br J Cancer. 2025 May 6. doi: 10.1038/s41416-025-03025-1.
It remains unclear whether there is a difference in overall survival (OS) benefit between (m)FOLFIRINOX and gemcitabine-nab-paclitaxel as preoperative regimens for localised pancreatic adenocarcinoma. This study aimed to investigate the outcome of patients with resected localised pancreatic adenocarcinoma following (m)FOLFIRINOX versus gemcitabine-nab-paclitaxel.
International multicentre retrospective study (16 centres, 8 countries, 3 continents), including consecutive patients after pancreatic resection for localised pancreatic adenocarcinoma following 2-6 months preoperative (m)FOLFIRINOX or gemcitabine-nab-paclitaxel (2010-2018). Primary endpoint was OS from start of preoperative chemotherapy. Cox regression analysis was performed to investigate the association of the preoperative chemotherapy regimen with OS, adjusted for confounders at diagnosis.
Overall, 935 patients were included after resection of localised pancreatic adenocarcinoma following preoperative (m)FOLFIRINOX (65%) or gemcitabine-nab-paclitaxel (35%). Preoperative chemotherapy regimen (m)FOLFIRINOX was not associated with OS (HR = 0.83 [95% CI 0.64-1.08]), compared to gemcitabine-nab-paclitaxel. Interaction analysis showed stronger effect of (m)FOLFIRINOX in patients with a lower (i.e., non-elevated/marginally elevated) serum CA19-9 at diagnosis (p = 0.032).
This international study found no OS benefit of preoperative (m)FOLFIRINOX in patients with resected localised pancreatic adenocarcinoma compared to gemcitabine-nab-paclitaxel.
对于（m）FOLFIRINOX方案和吉西他滨-纳米白蛋白紫杉醇作为局部胰腺癌术前治疗方案，其总生存（OS）获益是否存在差异仍不明确。本研究旨在探讨接受（m）FOLFIRINOX方案与吉西他滨-纳米白蛋白紫杉醇治疗后行手术切除的局部胰腺癌患者的预后。
一项国际多中心回顾性研究（涉及16个中心，8个国家，3个大洲），纳入2010 - 2018年间接受2 - 6个月术前（m）FOLFIRINOX方案或吉西他滨-纳米白蛋白紫杉醇治疗后行胰腺切除术的局部胰腺癌连续患者。主要终点为术前化疗开始后的总生存。进行Cox回归分析以研究术前化疗方案与总生存的相关性，并对诊断时的混杂因素进行校正。
总体而言，935例患者在接受术前（m）FOLFIRINOX方案（65%）或吉西他滨-纳米白蛋白紫杉醇方案（35%）治疗后行局部胰腺癌切除。与吉西他滨-纳米白蛋白紫杉醇相比，术前化疗方案（m）FOLFIRINOX与总生存无相关性（风险比[HR]=0.83[95%置信区间0.64 - 1.08]）。交互分析显示，（m）FOLFIRINOX方案对诊断时血清CA19-9水平较低（即未升高/轻度升高）的患者效果更强（p = 0.032）。
这项国际研究发现，与吉西他滨-纳米白蛋白紫杉醇相比，术前（m）FOLFIRINOX方案对接受手术切除的局部胰腺癌患者无总生存获益。
