Moving the Target on the Optimal Adjuvant Strategy for Resected Pancreatic Cancers: A Systematic Review with Meta-Analysis

被引：11

作者：

Galvano, Antonio ^{[1
]}

Castiglia, Marta ^{[1
]}

Rizzo, Sergio ^{[1
]}

Silvestris, Nicola ^{[2
]}

Brunetti, Oronzo ^{[2
]}

Vaccaro, Giovanni ^{[1
]}

Gristina, Valerio ^{[1
]}

Barraco, Nadia ^{[1
]}

Bono, Marco ^{[3
]}

Guercio, Giovanni ^{[3
]}

Graceffa, Giuseppa ^{[3
]}

Fulfaro, Fabio ^{[1
]}

Gori, Stefania ^{[4
]}

Bazan, Viviana ^{[5
]}

Russo, Antonio ^{[1
]}

机构：

[1] Univ Palermo, Dept Surg Oncol & Stomatol Sci, Med Oncol Unit, Via Vespro 129, Palermo 90127, Italy

[2] IRCCS Ist Tumori Giovanni Paolo II Bari, Med Oncol Unit, Viale Orazio Flacco 65, Bari 70124, Italy

[3] Univ Palermo, Dept Surg Oncol & Stomatol Sci, Via Vespro 129, Palermo 90127, Italy

[4] IRCCS Sacro Cuore Don Calabria Hosp, Oncol Dept, Verona 37024, Italy

[5] Univ Palermo, Sch Med, Dept Expt Biomed & Clin Neurosci, Via Vespro 129, Palermo 90127, Italy

来源：

CANCERS | 2020年 / 12卷 / 03期

关键词：

adjuvant; mFOLFIRINOX; pancreatic cancer; systematic review; chemotherapy; meta-analysis; SURGICAL COMPLICATIONS; DUCTAL ADENOCARCINOMA; MODIFIED FOLFIRINOX; OPEN-LABEL; CHEMOTHERAPY; GEMCITABINE; THERAPY; CHEMORADIOTHERAPY; SURGERY; PHASE-3;

D O I：

10.3390/cancers12030534

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Combination regimens have shown superiority over single agents in the adjuvant treatment of resected pancreatic cancer (PC), but there are no data supporting definition of the best regimen. This work aimed to compare the efficacy and safety of mFOLFIRINOX, gemcitabine +capecitabine, and gemcitabine +nab/paclitaxel in PC patients. A meta-analysis was performed for direct comparison between trials comparing combination regimens and gemcitabine monotherapy. Subsequently, an indirect comparison was made between trials investigating the efficacy and safety of mFOLFIRINOX, gemcitabine+capecitabine, and gemcitabine+nab/paclitaxel because of the same control arm (gemcitabine). A total of three studies met the selection criteria and were included in our indirect comparison. Indirect comparisons for efficacy outcomes showed a benefit in terms of DFS (disease-free survival)/EFS (event-free survival)/RFS (relapse-free survival) for both mFOLFIRINOX versus gemcitabine+capecitabine (HR 0.69, 95% CI 0.52-0.91) and versus gemcitabine+nab/paclitaxel (HR 0.67, 95% CI 0.50-0.90). No significant advantage was registered for OS (overall survival). Indirect comparisons for safety showed an increase in terms of G3-5 AEs (with the exception of neutropenia) for mFOLFIRINOX versus gemcitabine+capecitabine (RR 1.24, 95% CI 1.03-1.50), while no significant differences were observed versus gemcitabine+nab/paclitaxel. According to our results, mFOLFIRINOX is feasible and manageable and could represent a first option for fit PC resected patients.

引用

页数：14

共 53 条

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