Prior irinotecan exposure does not preclude benefit to liposomal irinotecan in patients with metastatic pancreatic ductal adenocarcinoma Journal Article

   

Authors:	Yu, K. H.; Cockrum, P.; Surinach, A.; Lamarre, N.; Wang, S.; O'Reilly, E. M.
Article Title:	Prior irinotecan exposure does not preclude benefit to liposomal irinotecan in patients with metastatic pancreatic ductal adenocarcinoma
Abstract:	Background: Subgroup analyses of the NAPOLI-1 study identified that among patients who were irinotecan naïve prior to entering the clinical trial, a survival benefit was observed between the study arm and control arm. This treatment benefit was not observed among those previously exposed to irinotecan. This study sought to understand the impact of prior exposure to irinotecan on clinical outcomes among patients treated with liposomal irinotecan in the real-world setting. Methods: This retrospective observational study utilized a nationwide electronic health record (EHR)-derived deidentified database. Data for adult patients with mPDAC treated with liposomal irinotecan-based regimens between January 2016 and October 2020 were analyzed. Patient characteristics, overall survival (OS), and progression-free survival (PFS) were assessed. Cox proportional hazard methods were used to calculate hazard ratios (HRs). HRs were adjusted for demographics and relevant clinical covariates. Results: Six hundred and seventy-five patients with mPDAC treated with a liposomal irinotecan-based regimen were included. The unadjusted OS HR was 1.3 (95% CI: 1.1–1.6, p < 0.001) and unadjusted PFS was HR 1.4 (95% CI: 1.2–1.7, p < 0.001). After adjustment for baseline characteristics, the adjusted OS HR was 1.0 (95% CI: 0.8–1.3, p = 0.8836) and the adjusted PFS HR was 1.1 (95% CI: 0.8–1.4, p = 0.5626). Conclusions: Prior irinotecan was not found to be a significant predictor of patient outcomes in those later treated with liposomal irinotecan. Thus, the results may inform the rationale for utilizing liposomal irinotecan combination therapy following prior irinotecan exposure in mPDAC, in particular where the prior irinotecan exposure was more distant in time. © 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
Keywords:	adult; overall survival; fluorouracil; antineoplastic agents; pancreatic neoplasms; antineoplastic agent; adenocarcinoma; antineoplastic combined chemotherapy protocols; irinotecan; pancreas carcinoma; folinic acid; pancreas tumor; leucovorin; pancreatic ductal adenocarcinoma; electronic health records; treatment options; pancreatic carcinoma; humans; human; real-world evidence
Journal Title:	Cancer Medicine
Volume:	12
Issue:	8
ISSN:	2045-7634
Publisher:	Wiley Blackwell
Date Published:	2023-04-01
Start Page:	9496
End Page:	9505
Language:	English
DOI:	10.1002/cam4.5714
PUBMED:	36934451
PROVIDER:	scopus
PMCID:	PMC10166959
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85150757273&doi=10.1002%2fcam4.5714&partnerID=40&md5=1fdfa8bc3cf0387f602f456504db7df7
Notes:	Article -- Export Date: 31 May 2023 -- Source: Scopus

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