• Heejung Chae, Hyehyun Jeong, Jaekyung Cheon, Hong Jae Chon, Hyewon Ryu, Il-Hwan Kim, Myoung Joo Kang, Jae Ho Jeong, Baek-Yeol Ryoo, Kyu-Pyo Kim, and Changhoon Yoo.
• Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, South Korea.
• Ther Adv Med Oncol. 2020 Jan 1; 12: 1758835920923424.

BackgroundFOLFIRINOX (fluorouracil, folinic acid, irinotecan plus oxaliplatin) is an effective standard first-line treatment option for advanced pancreatic ductal adenocarcinoma (PDAC). There is no clear consensus on the second-line treatment following progression on FOLFIRINOX. In this multicenter retrospective analysis, we evaluated the efficacy and tolerability of second-line nab-P/Gem (nab-paclitaxel and gemcitabine) after progression on FOLFIRNOX in PDAC.MethodsPatients with unresectable or metastatic PDAC who received nab-P/Gem after progression on FOLFIRINOX between February 2016 and February 2019 were identified from five referral cancer centers in South Korea. Baseline characteristics, treatment history, survival outcomes, and toxicity profile were obtained retrospectively from medical records.ResultsA total of 102 patients treated with second-line nab-P/Gem for advanced PDAC after progression on FOLFIRINOX were included. At the time of nab-P/Gem, the median age was 60 years, with males comprising 49.0%, and most (75.5%) had metastatic disease. Patients received a median of three cycles (range 1-12) of nab-P/Gem. The median overall survival (OS) and progression-free survival (PFS) from the start of second-line nab-P/Gem therapy were 9.8 (95% CI, 8.9-10.6) and 4.6 months (3.7-5.5), respectively. A partial response was achieved in 8.5%, and the disease control rate was 73.6%. From the start of first-line FOLFIRIOX, the OS1+2 and PFS1+2 were 20.9 (15.7-26.1) and 13.9 (10.8-17.0) months, respectively, with a 2-year survival rate of 45.1%. There was no treatment-related mortality and grade ⩾3 toxicity was observed in 60.2%.ConclusionOur results showed that nab-P/Gem was an effective and tolerable second-line treatment option in medically fit patients with advanced PDAC who progressed on first-line FOLFIRNOX.Clinical Trialsgov IdentifierNCT04133155.© The Author(s), 2020.

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