- Standard combination chemotherapy (gemcitabine+nab-paclitaxel or FOLFIRINOX) offers significantly better survival than nonstandard combinations (e.g., FOLFOX) or single-agent chemotherapy for recurrent pancreatic ductal adenocarcinoma (rPDAC).
Why this matters
- Findings support standard combination chemotherapy as the most efficacious chemotherapy option for rPDAC.
- Retrospective cohort of 223 patients with rPDAC in the Indiana University database (2008-2014).
- Funding: None.
- Of the 223 patients, 140 received chemotherapy, 71 did not receive chemotherapy, and 12 patients had missing data.
- Of the 140 patients who received chemotherapy, 53% received any standard combination, 34% received nonstandard combinations, and 13% received single-agent therapy:
- Any standard combination therapy yielded longer median OS (14 months; 95% CI, 9-17 months) vs 8 months with either nonstandard combinations (95% CI, 5-12 months) or single-agent therapy (95% CI, 6-12 months; P=.029).
- Multivariate cox regression of the entire cohort (n=223) found that median OS with:
- Standard combination chemotherapy was superior to single-agent therapy (HR, 0.54; P=.0246).
- Nonstandard combination chemotherapy was not superior to single-agent therapy (HR, 0.82; P=.4764).
- Use of any chemotherapy was superior to no chemotherapy (HR, 0.31; P<.0001>
- Single-center, observational, retrospective design.