A new network meta-analysis demonstrates that chemotherapy with S1 or FOLFRINOX (mFFX) is superior to gemcitabine/capecitabine (GemCap) for adjuvant treatment for pancreatic ductal adenocarcinoma.
A systematic review was conducted using MEDLINE, EMBASE, Cochrane Central and the American Society of Clinical Oncology abstracts to identify phase 3 randomised controlled trials that examined adjuvant systemic therapy in resected pancreatic cancer that were published up to 9 May 2019.
Twelve trials involving 4947 patients and nine different regimens (5-flourouracil/folinic acid [5-FU/FA], gemcitabine, gemcitabine/erlotinib, GemCap, mFFX, S1, chemoradiotherapy (CRT) and CRT with either 5-FU or gemcitabine) were identified.
S1 ranked best for overall (OS) and disease-free survival (DFS), followed by mFFX.
There was no significant difference between S1 and mFFX for OS (mean difference: 1.6 months; P=.8), but S1 had significantly longer DFS than mFFX (mean difference: 2.8 months; P<.001). S1 also ranked best for lowest overall and haematological grade 3/4 toxicities.
The authors say the findings that chemotherapy with S1 or mFFX improves survival after surgical resection and should be considered reasonable standard treatment options in the adjuvant setting.
