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Comparative Effectiveness of FOLFIRINOX vs. Nab-Paclitaxel and Gencitabine in patients with Metastatic Pancreatic Cancer: A Real-World Data Analysis

  • At: PPR SIG 2021 (2021)
  • Type: Digital
  • By: BöGER, Beatriz (Research and Innovation Center - Unimed Curitiba, Curitiba, Paraná, Brazil., Brazil)
  • Co-author(s): Beatriz Böger; Harli Pasquini Netto; Yohanna Ramires; Jolline Lind; Bianca Fontana Aguiar; Camila Cora Santos de Moraes Pereira; Moacir Pires Ramos; Mark Deeke; Jaime Luis Lopes Rocha.
  • Abstract:

    Introduction

    FOLFIRINOX is the currently preferable treatment for patients with patients with metastatic pancreatic adenocarcinoma (mPA) showing a good performance status (ECOG ≤1). However, the available comparative evidence of this regimen with other approaches is still inconclusive.

    Objectives

    To compare the effectiveness between FOLFIRINOX (fluoracil, leucovorin, irinotecan, oxaliplatin) and Nab-paclitaxel + gemcitabine (GnP) in mPA in the perspective of the health insurance system in Brazil.

    Methods

    The study was designed as a retrospective cohort (2018-2020). Secondary data was extracted from the health insurance computerized system (South region, Paraná State, Brazil). Patients with mPA treated with with GnP or FOLFIRINOX were selected for analysis. The number of administered chemotherapy regimens cycles per patient was evaluated. Patients with other therapeutic regimens or diagnoses other than mPA were excluded. Statistical descriptive analyses with categorial variables reported as frequencies and normal continuous variables as mean with standard deviation (SD). The comparison between both means was analysed by Mann- Whitney test. All statistical tests were performed with Graphd Prism 8.

    Results

    We included 20 patients using GnP and other 20 using FOLFIRINOX. The mean ages were of 68 (± 12) and 67 (± 7) years, respectively. The frequency of ECOG score ≤1 was 90% (n = 18/20) in the GnP group and 85% (n = 17/20) in FOLFIRINOX group. The median of administered cycles for GnP group was 2.2 ± 1.99 (0.3 - 8.0) and FOLFIRINOX group 4.0 ± 4.35 (1.0 -16.0) and these groups were statistically different (p=0.01; p<0.05). At the time of cross-sectional study, 2 patients (10%) were alive in the GnP group and 6 (30%) in the FOLFIRINOX group.

    Conclusion

    Patients with mPA in use of FOLFIRINOX remain in treatment for longer periods and die less compared to patients in use of GnP.

Last update 4 October 2019

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