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Background <p>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-<i>nab-</i>paclitaxel.</p> Methods <p>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-<i>nab-</i>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.</p> Results <p>Overall, 935 patients were included after resection of localised pancreatic adenocarcinoma following preoperative (m)FOLFIRINOX (65%) or gemcitabine-<i>nab</i>-paclitaxel (35%). Preoperative chemotherapy regimen (m)FOLFIRINOX was not associated with OS (HR = 0.83 [95% CI 0.64–1.08]), compared to gemcitabine-<i>nab</i>-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 (<i>p</i><sub>interaction</sub> = 0.032).</p> Conclusion <p>This international study found no OS benefit of preoperative (m)FOLFIRINOX in patients with resected localised pancreatic adenocarcinoma compared to gemcitabine-<i>nab</i>-paclitaxel.</p>

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Survival after neoadjuvant and induction FOLFIRINOX versus gemcitabine-nab-paclitaxel in patients with resected localised pancreatic adenocarcinoma: an international multicentre study

  • 期刊论文

  • 发表日期：

    2025年5月6日

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  • Thomas F. Stoop,
  • Y. H. Andrew Wu,
  • Atsushi Oba,
  • Mahsoem Ali,
  • Isabel M. Feld,
  • Mohammed H. Al-Musawi,
  • Ajay Jain,
  • Akio Saiura,
  • Alain Sauvanet,
  • Alessandro Coppola,
  • Ammar A. Javed,
  • Bas Groot Koerkamp,
  • Braden N. Miller,
  • Daisuke Hashimoto,
  • Damiano Caputo,
  • Dyre Kleive,
  • Elisabetta Sereni,
  • Geert Kazemier,
  • Giulio Belfiori,
  • Hirofumi Ishida,
  • Jacob L. van Dam,
  • Jeanne Dembinski,
  • Keiichi Akahoshi,
  • Keith J. Roberts,
  • Kimitaka Tanaka,
  • Knut J. Labori,
  • Massimo Falconi,
  • Michael G. House,
  • Motokazu Sugimoto,
  • Minoru Tanabe,
  • Naoto Gotohda,
  • Nikolaos Chatzizacharias,
  • Paul S. Krohn,
  • Safi Dokmak,
  • Salvador Rodriguez Franco,
  • Satoshi Hirano,
  • Stefan K. Burgdorf,
  • Stefano Crippa,
  • Sohei Satoi,
  • Trang K. Nguyen,
  • Tomohisa Yamamoto,
  • Toru Nakamura,
  • Yuta Ushida,
  • Vismaya Bachu,
  • William R. Burns,
  • Yosuke Inoue,
  • Yu Takahashi,
  • Zohra Aslami,
  • Richard D. Schulick,
  • Jin He,
  • Wells Messersmith,
  • Marc G. Besselink,
  • Richard A. Burkhart,
  • Johanna W. Wilmink,
  • Marco Del Chiaro,
  • Jacob L. van Dam,
  • Marco Del Chiaro,
  • Boris V. Janssen,
  • Rupaly Pande,
  • Oskar Franklin,
  • Olivier R. Busch,
  • Hiroyuki Ishida,
  • Toshitaka Sugawara,
  • Roeland F. de Wilde

摘要

Background

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.

Methods

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.

Results

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 (pinteraction = 0.032).

Conclusion

This international study found no OS benefit of preoperative (m)FOLFIRINOX in patients with resected localised pancreatic adenocarcinoma compared to gemcitabine-nab-paclitaxel.