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 |
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| Médium: | Journal Article |
| Jazyk: | angličtina |
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Netherlands
Elsevier Ireland Ltd
01.12.2015
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| ISSN: | 1040-8428, 1879-0461, 1879-0461 |
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| Abstract | •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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| AbstractList | •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. 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.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. 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. Highlights • 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. |
| Author | Nagrial, Adnan M. Pajic, Marina Yip, Desmond Horvath, Lisa G. Chin, Venessa T. Sjoquist, Katrin M. Biankin, Andrew V. |
| Author_xml | – sequence: 1 givenname: Adnan M. surname: Nagrial fullname: Nagrial, Adnan M. email: a.nagrial@garvan.org.au organization: The Kinghorn Cancer Centre, 370 Victoria Street, Darlinghurst, Sydney, NSW 2010, Australia – sequence: 2 givenname: Venessa T. surname: Chin fullname: Chin, Venessa T. organization: The Kinghorn Cancer Centre, 370 Victoria Street, Darlinghurst, Sydney, NSW 2010, Australia – sequence: 3 givenname: Katrin M. surname: Sjoquist fullname: Sjoquist, Katrin M. organization: NHMRC Clinical Trials Centre, University of Sydney, NSW, Australia – sequence: 4 givenname: Marina surname: Pajic fullname: Pajic, Marina organization: The Kinghorn Cancer Centre, 370 Victoria Street, Darlinghurst, Sydney, NSW 2010, Australia – sequence: 5 givenname: Lisa G. surname: Horvath fullname: Horvath, Lisa G. organization: The Kinghorn Cancer Centre, 370 Victoria Street, Darlinghurst, Sydney, NSW 2010, Australia – sequence: 6 givenname: Andrew V. surname: Biankin fullname: Biankin, Andrew V. organization: The Kinghorn Cancer Centre, 370 Victoria Street, Darlinghurst, Sydney, NSW 2010, Australia – sequence: 7 givenname: Desmond surname: Yip fullname: Yip, Desmond organization: Department of Medical Oncology, The Canberra Hospital, Garran, ACT, Australia |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/26481952$$D View this record in MEDLINE/PubMed |
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| Keywords | Systematic review Chemotherapy Second-line Trials Pancreatic cancer |
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| Snippet | •Use of second-line therapy was reported in 17% of randomised first-line studies.•Increased rates of second-line therapy correlated with improved overall... Highlights • Use of second-line therapy was reported in 17% of randomised first-line studies. • Increased rates of second-line therapy correlated with improved... There remains uncertainty regarding the optimal second-line chemotherapy in advanced pancreatic ductal adenocarcinoma (PDAC). The current recommendation of... |
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| Title | Second-line treatment in inoperable pancreatic adenocarcinoma: A systematic review and synthesis of all clinical trials |
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