Gemcitabine-resistant pancreatic cancer: a second-line option
Mené sur 417 patients atteints d'un cancer canalaire du pancréas de stade métastatique, cet essai randomisé international de phase III évalue l'efficacité, du point de vue de la survie globale, et la toxicité de l'ajout de nanoliposomes d'irinotécan à une chimiothérapie combinant fluorouracile et acide folinique après un traitement à base de gemcitabine
In The Lancet, Andrea Wang-Gillam and colleagues report on a randomised phase 3 trial (NAPOLI-1) in 417 patients with metastatic gemcitabine-resistant pancreatic cancer. The primary endpoint of overall survival was improved significantly with the combination of nanoliposomal irinotecan plus fluorouracil and folinic acid when compared with a control of fluorouracil and folinic acid (6·1 months [95% CI 4·8–8·9] vs 4·2 months [3·3–5·3]; hazard ratio [HR] 0·67, 95% CI 0·49–0·92). Subgroup analyses consistently favoured the combination treatment, further supporting a robust treatment effect on overall survival.