Efficacy of liposomal irinotecan+5-FU/LV vs. S-1 in gemcitabine-refractory metastatic pancreatic cancer: a real-world study using inverse probability of treatment weighting

被引：1

作者：

Imaoka, Hiroshi ^{[1
]}

Ikeda, Masafumi ^{[1
]}

Kobayashi, Satoshi ^{[2
]}

Ohba, Akihiro ^{[3
,4
]}

Ueno, Masayuki ^{[5
,6
]}

Suzuki, Yuko ^{[7
]}

Tsumura, Hidetaka ^{[8
]}

Kimura, Nana ^{[9
]}

Kawaguchi, Shinya ^{[10
]}

Kawamoto, Yasuyuki ^{[11
]}

Nakachi, Kohei ^{[12
]}

Tsuji, Kunihiro ^{[13
]}

Kobayashi, Noritoshi ^{[14
]}

Ashida, Reiko ^{[15
]}

Okano, Naohiro ^{[16
]}

Umemoto, Kumiko ^{[17
]}

Murohisa, Gou ^{[18
]}

Hosokawa, Ayumu ^{[19
]}

Asagi, Akinori ^{[20
]}

Nebiki, Hiroko ^{[21
]}

Suzuki, Rei ^{[22
]}

Terashima, Takeshi ^{[23
]}

Shibata, Ryusuke ^{[24
]}

Kawata, Kazuhito ^{[25
]}

Doi, Toshifumi ^{[26
]}

Ohyama, Hiroshi ^{[27
]}

Kitano, Yohei ^{[28
]}

Shioji, Kazuhiko ^{[29
]}

Okuyama, Hiroyuki ^{[30
]}

Naganuma, Atsushi ^{[31
]}

Negoro, Yuji ^{[32
]}

Sakamoto, Yasunari ^{[33
]}

Shimizu, Satoshi ^{[7
]}

Morizane, Chigusa ^{[3
]}

Ueno, Makoto ^{[2
]}

Furuse, Junji ^{[2
]}

Nagano, Hiroaki ^{[34
]}

机构：

[1] Natl Canc Ctr Hosp East, Dept Hepatobiliary & Pancreat Oncol, Kashiwa, Chiba, Japan

[2] Kanagawa Canc Ctr, Dept Gastroenterol, Yokohama, Kanagawa, Japan

[3] Natl Canc Ctr, Dept Hepatobiliary & Pancreat Oncol, Tokyo, Japan

[4] Shizuoka Canc Ctr, Div Gastrointestinal Oncol, Shizuoka, Japan

[5] Kurashiki Cent Hosp, Dept Gastroenterol & Hepatol, Kurashiki, Okayama, Japan

[6] Kyoto Univ, Grad Sch Med, Dept Gastroenterol & Hepatol, Kyoto, Japan

[7] Saitama Canc Ctr, Dept Gastroenterol, Saitama, Japan

[8] Hyogo Canc Ctr, Dept Gastroenterol Oncol, Akashi, Hyogo, Japan

[9] Toyama Univ, Dept Surg & Sci, Fac Med, Toyama, Japan

[10] Shizuoka Prefectural Gen Hosp, Dept Gastroenterol, Shizuoka, Japan

[11] Hokkaido Univ Hosp, Div Canc Ctr, Sapporo, Hokkaido, Japan

[12] Tochigi Canc Ctr, Dept Med Oncol, Utsunomiya, Japan

[13] Ishikawa Prefectural Cent Hosp, Dept Gastroenterol, Kanazawa, Ishikawa, Japan

[14] Yokohama City Univ, Med Ctr, Gastroenterol Ctr, Yokohama, Kanagawa, Japan

[15] Wakayama Med Univ, Dept Internal Med 2, Wakayama, Japan

[16] Kyorin Univ, Fac Med, Dept Med Oncol, Tokyo, Japan

[17] St Marianna Univ, Dept Clin Oncol, Sch Med, Kawasaki, Kanagawa, Japan

[18] Seirei Hamamatsu Gen Hosp, Dept Gastroenterol, Hamamatsu, Shizuoka, Japan

[19] Univ Miyazaki Hosp, Dept Clin Oncol, Miyazaki, Japan

[20] Natl Hosp Org Shikoku Canc Ctr, Dept Gastrointestinal Med Oncol, Matsuyama, Ehime, Japan

[21] Osaka City Gen Hosp, Dept Gastroenterol, Osaka, Japan

[22] Fukushima Med Univ, Dept Gastroenterol, Fukushima, Japan

[23] Kanazawa Univ Hosp, Dept Gastroenterol, Kanazawa, Ishikawa, Japan

[24] Kagoshima Univ, Grad Sch Med & Dent Sci, Digest & Lifestyle Dis, Kagoshima, Japan

[25] Hamamatsu Univ, Sch Med, Hepatol Div, Dept Internal Med 2, Hamamatsu, Shizuoka, Japan

[26] Kyoto Prefectural Univ Med, Dept Mol Gastroenterol & Hepatol, Kyoto, Japan

[27] Chiba Univ, Dept Gastroenterol, Chiba, Japan

[28] Asahikawa Med Univ, Dept Med, Div Gastroenterol, Asahikawa, Hokkaido, Japan

[29] Niigata Canc Ctr Hosp, Dept Internal Med, Niigata, Japan

[30] Kagawa Univ Hosp, Dept Med Oncol, Miki, Kagawa, Japan

[31] Natl Hosp Org Takasaki Gen Med Ctr, Dept Gastroenterol, Gunma, Japan

[32] Kochi Hlth Sci Ctr, Dept Med Oncol, Kochi, Japan

[33] Int Univ Hlth & Welf Atami Hosp, Dept Gastroenterol & Hepatol, Shizuoka, Japan

[34] Yamaguchi Univ, Grad Sch, Dept Gastroenterol Breast & Endocrine Surg, Ube, Yamaguchi, Japan

来源：

JOURNAL OF GASTROENTEROLOGY | 2024年

关键词：

Pancreatic cancer; Second line; Liposomal irinotecan; S-1; PHASE-II TRIAL; PLUS S-1; OXALIPLATIN; SURVIVAL; TRENDS;

D O I：

10.1007/s00535-024-02186-9

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

BackgroundS-1 monotherapy had previously been widely used as a second-line treatment for pancreatic cancer (PC) after gemcitabine-based chemotherapy mainly in Japan. Based on the results of the NAPOLI-1 trial, the recommended second-line therapy is now liposomal irinotecan plus fluorouracil/folinic acid (nal-IRI+5-FU/LV). However, there have been no studies comparing nal-IRI+5-FU/LV therapy with S-1 monotherapy.MethodsThe main objective of this study was to compare overall survival (OS) in patients treated with nal-IRI+5-FU/LV and those treated with S-1 monotherapy as second-line treatments, using the inverse probability of treatment weighting (IPTW) method. This study was conducted in 31 institutions participating in Japan Oncology Network in Hepatobiliary and Pancreas. To minimize potential biases due to the retrospective design, IPTW analysis was performed with multiple imputation, and imputed IPTW-adjusted hazard ratios and corresponding 95% confidence intervals (CIs) were estimated using a Cox proportional hazards model and combined into pooled estimates.ResultsA total of 463 metastatic PC patients were enrolled in this study (257 in the S-1 monotherapy group and 206 in the nal-IRI+5-FU/LV group). The median OS was 7.50 months (95% CI 4.18-12.69 months) in the nal-IRI+5-FU/LV group and 5.72 months (95% CI 2.76-10.79 months) in the S-1 monotherapy group. In the IPTW-adjusted Cox proportional hazards model, nal-IRI+5-FU/LV was associated with a significant OS benefit (pooled IPTW-adjusted hazard ratio, 0.779; 95% CI 0.399-0.941; p=0.025).ConclusionThese findings support the use of nal-IRI+5-FU/LV as standard second-line treatment for PC patients after gemcitabine-based chemotherapy.

引用

页码：368 / 369

页数：12

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