The online version of this article (https://doi.org/10.1007/s12325-018-0784-z) contains supplementary material, which is available to authorized users.
To view enhanced digital features for this article go to https://doi.org/10.6084/m9.figshare.7028858.
nab-Paclitaxel plus gemcitabine (nab-P + G) and FOLFIRINOX (FFX) are among the most common first-line (1L) therapies for metastatic adenocarcinoma of the pancreas (MPAC), but real-world data on their comparative effectiveness are limited.
This retrospective cohort study compared the efficacy and safety of 1L nab-P + G versus FFX, overall and under specific treatment sequences. Medical records were reviewed by 215 US physicians who provided information on MPAC patients who initiated 1L therapy with nab-P + G or FFX between April 1, 2015 and December 31, 2015. Study outcomes were overall survival (OS) and tolerability. OS was compared using Kaplan–Meier curves and adjusted Cox proportional hazards models.
In total, 654 medical records were reviewed, including those of 337 and 317 patients initiated on nab-P + G and FFX as 1L MPAC therapy, respectively. nab-P + G-initiated patients were older, less likely to have ECOG ≤ 1, and had more comorbidities than FFX-initiated patients. Median OS (mOS) was 12.1 and 13.8 months for nab-P + G- and FFX-initiated patients, respectively (HR = 0.99, P = 0.96). Among patients with ECOG ≤ 1, mOS was 14.1 and 13.7 months, respectively (HR = 1.00, P = 0.99). Among patients with 1L nab-P + G and FFX, 36.1% and 41.3% received 2L therapy and experienced mOS of 16.3 and 16.6 months, respectively (HR = 1.04, P = 0.76). The rates of diarrhea, fatigue, mucositis, and nausea and vomiting were significantly higher in the FFX than nab-P + G cohort.
The real-world survival was similar between patients receiving 1L nab-P + G or FFX both overall and among patients who received active 2L treatments. In addition, nab-P + G was associated with significantly lower rates of common AEs compared with FFX.
Supplementary material 1 (DOCX 383 kb)12325_2018_784_MOESM1_ESM.docx
American Cancer Society. Cancer facts and figures 2017. https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2017.html. Accessed July 2017.
Tempero MA, Malafa MP, Al-Hawary M, et al. NCCN clinical practice guidelines in oncology. Pancreatic adenocarcinoma, Version 2.2017. J Natl Compr Cancer Netw. 2017;15:1028–61. CrossRef
CancerWorld. Management of metastatic pancreatic cancer: current strategies and future directions. http://cancerworld.net/e-grandround/management-of-metastatic-pancreatic-cancer-current-strategies-and-future-directions/. Accessed July 2017.
Cancer.Net. Pancreatic cancer: treatment options. https://www.cancer.net/cancer-types/pancreatic-cancer/treatment-options. Accessed June 2018.
Food and Drug Administration (FDA). ABRAXANE prescribing information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/021660s037lbl.pdf. Accessed November 2017.
Von Hoff DD, Ervin T, Arena FP, et al. Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine. N Engl J Med. 2013;369:1691–703. CrossRef
Hollmann S, Alloul K, Attard C, Kavan P. PD-0018 An indirect treatment comparison and cost effectiveness analysis comparing FOLFIRINOX with nab-paclitaxel plus gemcitabine for first-line treatment for patients with metastatic pancreatic cancer. Ann Oncol. 2014;25:ii11–2 (Abstract). CrossRef
Gharaibeh M, McBride A, Bootman JL, Cranmer LD, Abraham I. Economic evaluation for the United States (US) of gemcitabine (GEM), nab-paclitaxel plus gemcitabine (NAB-P+GEM), and FOLFIRINOX as first-line treatment for metastatic pancreatic cancer (MPC). J Med Econ 2015;33:6605.
Cartwright TH, Parisi M, Espirito JL, et al. Treatment outcomes with first-line (1L) nab-paclitaxel + gemcitabine (AG) and FOLFIRINOX (FFX) in metastatic pancreatic adenocarcinoma (mPAC). J Clin Oncol. 2017;35:e18147. CrossRef
Braiteh F, Patel MB, Parisi M, et al. Comparative effectiveness and resource utilization of nab-paclitaxel plus gemcitabine vs FOLFIRINOX or gemcitabine for the first-line treatment of metastatic pancreatic adenocarcinoma in a US community setting. Cancer Manag Res. 2017;9:141. CrossRefPubMedPubMedCentral
Wang Y, Chen L, Camateros P, et al. Comparative effectiveness of FOLFIRINOX or nab-paclitaxel plus gemcitabine in locally advanced or metastatic pancreatic cancer: a population-based analysis. J Clin Oncol. 2016;34:6561. CrossRef
Patel L, Hollmann S, Attard C, Maroun J. Real-world experience with FOLFIRINOX: a review of Canadian and international registries. Oncol Exch. 2014;13:18–23.
- Comparative Effectiveness of nab-Paclitaxel Plus Gemcitabine vs FOLFIRINOX in Metastatic Pancreatic Cancer: A Retrospective Nationwide Chart Review in the United States
James E. Signorovitch
Cheryl Q. Xiang
John L. Marshall
- Springer Healthcare
- Advances in Therapy
Print ISSN: 0741-238X
Elektronische ISSN: 1865-8652
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
e.Med Kampagnen-Visual, Mail Icon II