Second-line treatment in inoperable pancreatic adenocarcinoma: A systematic review and synthesis of all clinical trials

•Use of second-line therapy was reported in 17% of randomised first-line studies.•Increased rates of second-line therapy correlated with improved overall survival.•71 studies of second-line therapy in advanced PDAC were identified.•Anti-cancer treatment improved survival compared to best supportive...

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Vydáno v:Critical reviews in oncology/hematology Ročník 96; číslo 3; s. 483 - 497
Hlavní autoři: Nagrial, Adnan M., Chin, Venessa T., Sjoquist, Katrin M., Pajic, Marina, Horvath, Lisa G., Biankin, Andrew V., Yip, Desmond
Médium: Journal Article
Jazyk:angličtina
Vydáno: Netherlands Elsevier Ireland Ltd 01.12.2015
Témata:
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Chemotherapy
Clinical Trials as Topic
Hematology, Oncology and Palliative Medicine
Humans
Pancreatic cancer
Pancreatic Neoplasms - drug therapy
Prospective Studies
Salvage Therapy
Second-line
Systematic review
Trials
Systematic review
Chemotherapy
Second-line
Trials
Pancreatic cancer
ISSN:1040-8428, 1879-0461, 1879-0461
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Shrnutí:•Use of second-line therapy was reported in 17% of randomised first-line studies.•Increased rates of second-line therapy correlated with improved overall survival.•71 studies of second-line therapy in advanced PDAC were identified.•Anti-cancer treatment improved survival compared to best supportive care.•Greater utilisation of second-line chemotherapy in advanced PDAC may improve outcomes. There remains uncertainty regarding the optimal second-line chemotherapy in advanced pancreatic ductal adenocarcinoma (PDAC). The current recommendation of 5-fluorouracil and oxaliplatin may not be relevant in current practice, as FOLFIRINOX (5-fluorouracil, leucovorin, irinotecan and oxaliplatin) has become a more popular first line therapy in fit patients. The majority of studies in this setting are single-arm Phase II trials with significant heterogeneity of patient populations, treatments and outcomes. In this review, we sought to systematically review and synthesise all prospective data available for the second-line treatment of advanced PDAC.
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ISSN:1040-8428
1879-0461
1879-0461
DOI:10.1016/j.critrevonc.2015.07.007