Abstract 376P
Background
The most common chemotherapy regimens used in pancreatic cancer are FOLFIRINOX (Fx) and gemcitabine plus nab paclitaxel (G+P).Both are used in borderline resectable (BRPC),locally advanced (LAPC) or advanced metastatic (M) stage. This study analysed the safety and efficacy of these regimens as frontline treatment of pancreatic cancer.
Methods
A retrospective review of case records of pancreatic cancer patients treated from Oct 2019 to jan 2023 with either Fx or G+P as frontline therapy was done. Patients having complete data for efficacy and safety analysis were included. Efficacy measures were progression free survival ( PFS ) ,objective response rate (ORR), Disease control rate ( DCR) and overall survival ( OS). Stastical analysis was done with Kaplan meier analysis, log rank test and cox proportional hazards model.
Results
Of 181 patients screened 150 were finally analysed. In metastatic patients (n=47 vs n=30), ORR was 46 % vs 50% (p=0.272), DCR 85 % vs 73% (p=0.245), median PFS: 5 vs 6 months (p=0.481) Hazard ratio(HR)= 1.19( 95% CI 0.71- 1.98), median OS : 8 vs 10.5 months ( p = 0.35) HR= 1.26( 95% CI 0.75- 2.09) with G+P vs Fx respectively. In LAPC patients (n=16 vs n=16) ORR was 37.5%vs 68 % (p=0.208), DCR 75.4 % vs 87.5 % (p=0.654), median EFS: 7 vs 7.5 months (p=0.693) HR= 0.849( 95% CI 0.36- 1.98), median OS : 13 vs 15.5 months ( p = 0.84) HR= 1.08( 95% CI 0.47- 2.47) with G+P vs Fx respectively. In BRPC patients (n=23 vs n=18) ORR was 34 % vs 55 % (p=0.38), DCR 69 % vs 83 % (p=0.46), median EFS: 6 vs 8.5 months (p=0.219) ,HR=1.69( 95% CI 0.70- 4.10), median OS : 9.5 vs 17.5 months ( p = 0.02) HR= 3.158 (95% CI 1.1- 9.05) with G+P vs Fx respectively. The rate of grade 3 or 4 toxicities was 21% vs 45 % in G+P ( peripheral neuropathy & fatigue) vs Fx ( diarrhea, mucositis & myelosuppression) respectively.
Conclusions
There are no significant differences in ORR,DCR and OS between Fx & G+P across different settings in this real world study. Despite the limitations of a real-world study, G+P appears to have a better safety profile and can be considered as an acceptable regimen in first-line treatment of pancreatic cancer. This study demonstrates the overall limited survival in pancreatic cancer and highlights the need for more effective therapies.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.