Comparison between different therapeutic sequences in patients affected by metastatic pancreatic ductal adenocarcinoma.

• DOI: 10.1200/jco.2024.42.3_suppl.674
• Publication Date: 2024-01-22T21:12:58Z
• Authors: Andrea Pretta; Riccardo Giampieri; Federico Nichetti; Pina Ziranu; Alessio Lupi; Giusy Moledda; Paola Andena; Cristiano Felicetti; Alessandra Pia D'...; Chiara Carlotta P...; Claudia Codipietro; Simone Rota; Daiana Rizzo; Giorgia Sanna; Eleonora Lai; Marco Puzzoni; Valeria Pusceddu; Rossana Berardi; Monica Niger; Mario Scartozzi
• Keywords: 03 medical and health sciences; 0302 clinical medicine

674 Background: The first-line treatment of metastatic pancreatic cancer involves different therapeutic regimens, among them, mFOLFIRINOX and gemcitabine-nabpaclitaxel. However, it remains to be clarified which sequence might correlate with better outcomes. The aim of our work was to evaluate which sequence leads to better overall survival in this setting. Methods: We retrospectively collected data from 358 patients affected by stage IV pancreatic ductal adenocarcinoma from 3 different Italian Institutions. Patients received mFOLFIRINOX or gemcitabine plus nabpaclitaxel as first-line chemotherapy, followed by a second-line non-cross-resistant chemotherapy (gemcitabine or fluoropyrimidine-based combinations). Survival distribution was assessed by Kaplan-Meier curves. The primary endpoint was median overall survival. Statistical analysis was performed with MedCalc package. Results: The median age was 66 (± 9), 195 (54,4%) were male and 163 (45,6%) were female. 292 (81,5%) patients start gemcitabine plus nabpaclitaxel as first line treatment, while 66 (18,5%) patients start mFOLFIRINOX first-line therapy. No statistically significant differences in terms of mOS were observed between the two mFOLFIRINOX and gemcitabine-nabpaclitaxel groups: 16 versus 15 months, respectively, p = 0,2). No significant differences were found in terms of mPFS either: 7 versus 8 months, respectively, p = 0,3). Conclusions: The results of our retrospective study showed no statistically significant survival advantage between the sequences starting with mFOLFIRINOX or with gemcitabine-nabpaclitaxel. Further studies will be necessary to establish the effectiveness of new therapeutic schemes to be introduced into clinical practice in order to define a better therapeutic algorithm.