Stage 4 pancreatic cancer survival improves by a 4-drug chemotherapy regimen

A four-drug chemotherapy regimen provided longer overall survival than a two-drug combination in a Phase 3 clinical trial for metastatic pancreatic ductal adenocarcinoma. The study is believed to be the first metastatic pancreatic cancer study in nearly a decade to have a positive endpoint for overall survival.

For the study, 770 patients were randomly assigned to one of two chemotherapy regimens. Patients in the four-drug group had an overall survival of 11.1 months, compared with 9.2 months for those in the two-drug arm.

Progression-free survival also increased with the four-drug therapy - 7.4 months versus 5.6 months with the two-drug regimen. Several side effects, such as diarrhea, nausea and low levels of potassium, were more common in patients taking the four-drug treatment, but anemia and low levels of white blood cells were more common in those taking the two drugs.

The four-drug regimen consisted of liposomal irinotecan, 5-fluorouracil/leucovorin and oxaliplatin - together referred to as NALIRIFOX. The two-drug therapy consisted of nab-paclitaxel and gemcitabine.The clinical trial included patients in more than 25 countries.

Reference:

NAPOLI-3: A Randomized, Open-label Phase 3 Study of Liposomal Irinotecan + 5-fluorouracil/leucovorin + Oxaliplatin (NALIRIFOX) versus Nab-paclitaxel + Gemcitabine in Treatment-naïve Patients with Metastatic Pancreatic Ductal Adenocarcinoma (mPDAC),UN