Nanoliposomal irinotecan (Nal-IRI)-based chemotherapy after irinotecan -based chemotherapy in patients with pancreas cancer.


Journal

Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]
ISSN: 1424-3911
Titre abrégé: Pancreatology
Pays: Switzerland
ID NLM: 100966936

Informations de publication

Date de publication:
Mar 2021
Historique:
received: 30 07 2020
revised: 08 09 2020
accepted: 12 10 2020
pubmed: 21 1 2021
medline: 6 11 2021
entrez: 20 1 2021
Statut: ppublish

Résumé

Nanoliposomal irinotecan (Nal-IRI) is a preferred second-line treatment for metastatic pancreas cancer. It is unclear, however, whether patients who had received irinotecan derive benefit. Medical records of metastatic pancreas cancer patients who had received irinotecan and then Nal-IRI were reviewed. The primary endpoint was overall survival after the initiation of Nal-IRI (an a priori threshold of >4 months defined success); adverse events and quotes from the medical record on decision-making were also recorded. Sixty four patients met eligibility criteria with a median age of 65 years (range: 36, 80 years). The median overall survival from initiation of Nal-IRI was 5.1 months (95% confidence interval (CI): 4.3, 5.6 months). An exploratory comparison, based on no cancer progression with irinotecan versus progression, showed improved survival with Nal-IRI in the former group: 6.1 months (95% CI: 5.1, 9.3 months) versus 4.3 months (95% CI: 2.3, 4.8 months); p = 0.0006. Nal-IRI adverse events occurred as expected. Qualitative data illustrate several themes, including "limited treatment options," which appeared to drive the decision to prescribe Nal-IRI. Nal-IRI might be considered in pancreas cancer patients who had received irinotecan, particularly in the absence of disease progression with the latter.

Sections du résumé

BACKGROUND BACKGROUND
Nanoliposomal irinotecan (Nal-IRI) is a preferred second-line treatment for metastatic pancreas cancer. It is unclear, however, whether patients who had received irinotecan derive benefit.
METHODS METHODS
Medical records of metastatic pancreas cancer patients who had received irinotecan and then Nal-IRI were reviewed. The primary endpoint was overall survival after the initiation of Nal-IRI (an a priori threshold of >4 months defined success); adverse events and quotes from the medical record on decision-making were also recorded.
RESULTS RESULTS
Sixty four patients met eligibility criteria with a median age of 65 years (range: 36, 80 years). The median overall survival from initiation of Nal-IRI was 5.1 months (95% confidence interval (CI): 4.3, 5.6 months). An exploratory comparison, based on no cancer progression with irinotecan versus progression, showed improved survival with Nal-IRI in the former group: 6.1 months (95% CI: 5.1, 9.3 months) versus 4.3 months (95% CI: 2.3, 4.8 months); p = 0.0006. Nal-IRI adverse events occurred as expected. Qualitative data illustrate several themes, including "limited treatment options," which appeared to drive the decision to prescribe Nal-IRI.
CONCLUSION CONCLUSIONS
Nal-IRI might be considered in pancreas cancer patients who had received irinotecan, particularly in the absence of disease progression with the latter.

Identifiants

pubmed: 33468394
pii: S1424-3903(20)30793-6
doi: 10.1016/j.pan.2020.10.042
pii:
doi:

Substances chimiques

Antineoplastic Agents 0
Dosage Forms 0
Liposomes 0
Irinotecan 7673326042

Types de publication

Clinical Trial, Phase III Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

379-383

Informations de copyright

Copyright © 2020. Published by Elsevier B.V.

Auteurs

Caleb J Smith (CJ)

Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.

Tanios S Bekaii-Saab (TS)

Division of Hematology/Oncology, Mayo Clinic, 2779 E. Mayo Boulevard, Phoenix, AZ, USA.

Kathryn D Cook (KD)

Division of Medical Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.

Rachel A Eiring (RA)

Division of Medical Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.

Thorvardur R Halfdanarson (TR)

Division of Medical Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.

Mina Hanna (M)

Mayo Clinic Health System, 404 W. Fountain Street, Albert Lea, MN, USA.

Zhaohui Jin (Z)

Division of Medical Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.

Jacob A Jochum (JA)

Division of Medical Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.

Wen Wee Ma (WW)

Division of Medical Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.

Jessica L Mitchell (JL)

Division of Medical Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.

Henry C Pitot (HC)

Division of Medical Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.

Aminah Jatoi (A)

Division of Medical Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA. Electronic address: jatoi.aminah@mayo.edu.

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Classifications MeSH