Nanoliposomal irinotecan (Nal-IRI)-based chemotherapy after irinotecan -based chemotherapy in patients with pancreas cancer
Nanoliposomal irinotecan (Nal-IRI)-based chemotherapy after irinotecan -based chemotherapy in patients with pancreas cancer
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DOI：
10.1016/j.pan.2020.10.042
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发表时间：
2021-03-12
期刊：
影响因子：
3.6
通讯作者：
Jatoi, Aminah
中科院分区：
文献类型：
--
作者：
Smith, Caleb J.;Bekaii-Saab, Tanios S.;Jatoi, Aminah
背景：纳米脂质体伊立替康(Nal-IRI)是治疗转移性胰腺癌的首选二线药物。然而，目前尚不清楚接受伊立替康治疗的患者是否受益。方法：回顾接受伊立替康和Nal-IRI治疗的转移性胰腺癌患者的医疗记录。主要终点是接受NAL-IRI治疗后的总存活率(先验阈值为>；4个月的成功)；不良事件和决策方面的病历引用也被记录下来。结果：64名患者符合资格标准，中位年龄为65岁(范围：36-80岁)。中位总生存期为5.1个月(95%可信区间为4.3，5.6个月)。一项基于伊立替康与伊立替康无癌症进展的探索性比较显示，前一组接受Nal-IRI治疗的患者存活率提高：6.1月(95%可信区间：5.1月，9.3个月)对4.3月(95%可信区间：2.3月，4.8月)；p=0.0006。NAL-IRI不良事件如预期发生。定性数据说明了几个主题，包括“有限的治疗选择”，这似乎推动了开Nal-IRI的决定。结论：Nal-IRI可能考虑用于接受伊立替康治疗的胰腺癌患者，特别是在后者没有疾病进展的情况下。(C)2020年由Elsevier B.V.代表IAP和EPC出版。
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: 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: 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: Nal-IRI might be considered in pancreas cancer patients who had received irinotecan, particularly in the absence of disease progression with the latter. (C) 2020 Published by Elsevier B.V. on behalf of IAP and EPC.