TY - JOUR
T1 - Survival after neoadjuvant and induction FOLFIRINOX versus gemcitabine-nab-paclitaxel in patients with resected localised pancreatic adenocarcinoma
T2 - an international multicentre study
AU - International Consortium on Pancreatic Cancer Surgery and Oncology (ICON)
AU - Stoop, Thomas F.
AU - Wu, Y. H.Andrew
AU - Oba, Atsushi
AU - Ali, Mahsoem
AU - Feld, Isabel M.
AU - Al-Musawi, Mohammed H.
AU - Jain, Ajay
AU - Saiura, Akio
AU - Sauvanet, Alain
AU - Coppola, Alessandro
AU - Javed, Ammar A.
AU - Groot Koerkamp, Bas
AU - Miller, Braden N.
AU - Hashimoto, Daisuke
AU - Caputo, Damiano
AU - Kleive, Dyre
AU - Sereni, Elisabetta
AU - Kazemier, Geert
AU - Belfiori, Giulio
AU - Ishida, Hirofumi
AU - van Dam, Jacob L.
AU - Dembinski, Jeanne
AU - Akahoshi, Keiichi
AU - Roberts, Keith J.
AU - Tanaka, Kimitaka
AU - Labori, Knut J.
AU - Falconi, Massimo
AU - House, Michael G.
AU - Sugimoto, Motokazu
AU - Tanabe, Minoru
AU - Gotohda, Naoto
AU - Chatzizacharias, Nikolaos
AU - Krohn, Paul S.
AU - Dokmak, Safi
AU - Rodriguez Franco, Salvador
AU - Hirano, Satoshi
AU - Burgdorf, Stefan K.
AU - Crippa, Stefano
AU - Satoi, Sohei
AU - Nguyen, Trang K.
AU - Yamamoto, Tomohisa
AU - Nakamura, Toru
AU - Ushida, Yuta
AU - Bachu, Vismaya
AU - Burns, William R.
AU - Inoue, Yosuke
AU - Takahashi, Yu
AU - Aslami, Zohra
AU - Schulick, Richard D.
AU - He, Jin
AU - Messersmith, Wells
AU - Besselink, Marc G.
AU - Burkhart, Richard A.
AU - Wilmink, Johanna W.
AU - Del Chiaro, Marco
AU - de Wilde, Roeland F.
AU - Sugawara, Toshitaka
AU - Ishida, Hiroyuki
AU - Busch, Olivier R.
AU - Franklin, Oskar
AU - Pande, Rupaly
AU - Janssen, Boris V.
AU - Del Chiaro, Marco
AU - van Dam, Jacob L.
N1 - Publisher Copyright:
© The Author(s), under exclusive licence to Springer Nature Limited 2025.
PY - 2025/7/27
Y1 - 2025/7/27
N2 - Background: It remains unclear whether there is a difference in overall survival (OS) benefit between (m)FOLFIRINOX and gemcitabine-nab-paclitaxel as preoperative regimens for localised pancreatic adenocarcinoma. This study aimed to investigate the outcome of patients with resected localised pancreatic adenocarcinoma following (m)FOLFIRINOX versus gemcitabine-nab-paclitaxel. Methods: International multicentre retrospective study (16 centres, 8 countries, 3 continents), including consecutive patients after pancreatic resection for localised pancreatic adenocarcinoma following 2–6 months preoperative (m)FOLFIRINOX or gemcitabine-nab-paclitaxel (2010–2018). Primary endpoint was OS from start of preoperative chemotherapy. Cox regression analysis was performed to investigate the association of the preoperative chemotherapy regimen with OS, adjusted for confounders at diagnosis. Results: Overall, 935 patients were included after resection of localised pancreatic adenocarcinoma following preoperative (m)FOLFIRINOX (65%) or gemcitabine-nab-paclitaxel (35%). Preoperative chemotherapy regimen (m)FOLFIRINOX was not associated with OS (HR = 0.83 [95% CI 0.64–1.08]), compared to gemcitabine-nab-paclitaxel. Interaction analysis showed stronger effect of (m)FOLFIRINOX in patients with a lower (i.e., non-elevated/marginally elevated) serum CA19-9 at diagnosis (pinteraction = 0.032). Conclusion: This international study found no OS benefit of preoperative (m)FOLFIRINOX in patients with resected localised pancreatic adenocarcinoma compared to gemcitabine-nab-paclitaxel.
AB - Background: It remains unclear whether there is a difference in overall survival (OS) benefit between (m)FOLFIRINOX and gemcitabine-nab-paclitaxel as preoperative regimens for localised pancreatic adenocarcinoma. This study aimed to investigate the outcome of patients with resected localised pancreatic adenocarcinoma following (m)FOLFIRINOX versus gemcitabine-nab-paclitaxel. Methods: International multicentre retrospective study (16 centres, 8 countries, 3 continents), including consecutive patients after pancreatic resection for localised pancreatic adenocarcinoma following 2–6 months preoperative (m)FOLFIRINOX or gemcitabine-nab-paclitaxel (2010–2018). Primary endpoint was OS from start of preoperative chemotherapy. Cox regression analysis was performed to investigate the association of the preoperative chemotherapy regimen with OS, adjusted for confounders at diagnosis. Results: Overall, 935 patients were included after resection of localised pancreatic adenocarcinoma following preoperative (m)FOLFIRINOX (65%) or gemcitabine-nab-paclitaxel (35%). Preoperative chemotherapy regimen (m)FOLFIRINOX was not associated with OS (HR = 0.83 [95% CI 0.64–1.08]), compared to gemcitabine-nab-paclitaxel. Interaction analysis showed stronger effect of (m)FOLFIRINOX in patients with a lower (i.e., non-elevated/marginally elevated) serum CA19-9 at diagnosis (pinteraction = 0.032). Conclusion: This international study found no OS benefit of preoperative (m)FOLFIRINOX in patients with resected localised pancreatic adenocarcinoma compared to gemcitabine-nab-paclitaxel.
UR - https://www.scopus.com/pages/publications/105010889743
U2 - 10.1038/s41416-025-03025-1
DO - 10.1038/s41416-025-03025-1
M3 - Article
C2 - 40328917
AN - SCOPUS:105010889743
SN - 0007-0920
VL - 133
SP - 76
EP - 84
JO - British Journal of Cancer
JF - British Journal of Cancer
IS - 1
ER -