Work

Efficacy and Safety of Different Sequences for mFOLFIRINOX (or SOXIRI) and Gemcitabine Plus Albumin-Bound Paclitaxel in Unresectable Pancreatic Cancer

Year: 2025

Type: article

Abstract: Aim: This study aimed to evaluate and compare the therapeutic efficacy and adverse effects of two sequential treatment strategies in patients with unresectable advanced pancreatic cancer (aPC), albumin-bound-paclitaxel plus gemcitabine administered follow by mFOLFIRINOX or SOXIRI (AG-F(S)FX m ) versus the reverse sequence regimen F(S)FX m -AG. Methods: In this retrospective analysis, patients with unresectable advanced pancreatic cancer (aPC) who received either AG-F(S)FX m or F(S)FX m -AG were included. Key endpoints were overall survival (OS), progression-free survival (PFS), and treatment-related toxicity. Survival outcomes were assessed using Kaplan-Meier curves, and differences between groups were examined through hazard ratios (HR) and corresponding p-values. Results: A total of 107 patients were analyzed, including 49 who underwent AG-F(S)FX m and 58 who received F(S)FX m -AG. The median OS was 14.60 months for F(S)FX m -AG and 12.20 months for AG-F(S)FX m (HR: 1.04, 95% CI: 0.69– 1.57, p= 0.86). Median PFS1, median PFS2 and median total PFS (tPFS) were 5.20 months versus 4.83 months (HR: 0.81, 95% CI: 0.54– 1.21, p= 0.3), 4.53 months versus 5.77 months (HR: 1.15, 95% CI: 0.71– 1.88, p= 0.60) and 13.80 months versus 12.80 months (HR: 0.90, 95% CI: 0.55– 1.48, p= 0.67) for F(S)FX m -AG versus AG-F(S)FX m . Given their comparable efficacy, we further compared the safety profiles of both regimens. The toxicity profiles differed between the two sequential treatments. Leukopenia was more common with first-line AG, while gastrointestinal toxicity, fatigue, and sensory neuropathy were more frequent with first-line F(S)FX m . Additionally, elevated aspartate aminotransferase was more often reported with second-line AG. Conclusion: Both AG-F(S)FX m and F(S)FX m -AG demonstrated comparable efficacy in treating aPC, with F(S)FX m -AG showing a trend toward improved outcomes. The choice of sequential treatment should be guided by toxicity profiles and patient-specific factors. Further prospective studies are warranted to optimize treatment sequencing and personalize therapy for improved patient outcomes. Keywords: advanced pancreatic cancer, AG, mFOLFIRINOX, SOXIRI and efficacy

Source: ImmunoTargets and Therapy

DOI: 10.2147/itt.s530434

Authors: Silan Huang, Lingli Huang, Dongsheng Zhang, Qi Jiang, Fenghua Wang, Guifang Guo

Institutions: Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Sun Yat-sen University

Language: English

Topic: Pancreatic and Hepatic Oncology Research

Subfield: Oncology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,320