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ASCO Webinar Summary: Pancreatic Cancer

Liposomal irinotecan plus fluorouracil/leucovorin versus folfirinox as the second-line chemotherapy for patients with metastatic pancreatic cancer

(Link for full article)

 Author, Company : Hongjae Chon, MD, Korean Cancer Study Group (KCSG)

Abstract Number: 4624

Indications : Metastatic pancreatic cancer (mPC)

Interventions : Liposomal irinotecan plus fluorouracil/leucovorin, folfirinox

Background and objectives:

There is no specific preference for second line (2L) treatment for patients with mPC. The study aimed to compare the efficacy and tolerability between liposomal irinotecan plus FL and folfirinox in 378 mPC patients who failed on first line gemcitabine-based treatment. The drugs were analyses on the following:

  • Primary endpoints: PFS
  • Secondary endpoints: OS, overall response rate, and tolerability

Results and observations:

There was no significant difference between two groups with respect to baseline characteristics. The median follow-up time was 6 months.

  • The median PFS (nal-IRI/FL, 3.7 months vs. folfirinox, 5.0 months) and OS (nal-IRI/FL, 7.7 months vs. folfirinox, 9.7 months) were comparable between two groups
  • The overall response rate was not significantly different between two groups (nal-IRI/FL, 14% vs. folfrinox, 16%)
  • Grade 3 neutropenia or higher were more frequently observed in folfirinox (47.2%) than nal-IRI/FL (35%)
  • Grade 3 peripheral neuropathy was common in folfirionx (5.9%) group than nal-IRI/FL (1.0%)


Safety and efficacy outcomes are similar for the both, nal-IRI/FL and folfirinox regimens in patients of mPC (who failed to control the disease using gemcitabine therapy).

In patients with liver metastasis, folfirinox is preferred.

Key take-away:

The retrospective study on 378 mPC 2L patients, testing the safety, efficacy and tolerability of liposomal irinotecan plus fluorouracil/ leucovorin (FL) and folfirinox showed that there was no significant difference between two regimens.

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