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Multicenter Study
. 2024 Nov;31(11):816-829.
doi: 10.1002/jhbp.12066. Epub 2024 Aug 16.

Outcomes of patients with initially unresectable pancreatic cancer who underwent conversion surgery after FOLFIRINOX or gemcitabine plus nab-paclitaxel chemotherapy: A multicenter retrospective cohort study (PC-CURE-1)

Naohiro Okano  1 , Manabu Kawai  2 , Makoto Ueno  3 , Xianjun Yu  4 , Yosuke Inoue  5 , Shinichiro Takahashi  6 , Wenquan Wang  4 , Hidenori Takahashi  7 , Yukiyasu Okamura  8 , Soichiro Morinaga  9 , Ippei Matsumoto  10 , Yasuhiro Shimizu  11 , Kazuhiro Yoshida  12 , Tomohisa Yamamoto  13 , Masayuki Ohtsuka  14 , Yoshikuni Inokawa  15 , Satoshi Nara  16 , Jun Tamura  17 , Satoru Shinoda  17 , Kouji Yamamoto  17 , Hiroki Yamaue  2 , Junji Furuse  1   3 ; PC‐CURE‐1 study group
Affiliations
Multicenter Study

Outcomes of patients with initially unresectable pancreatic cancer who underwent conversion surgery after FOLFIRINOX or gemcitabine plus nab-paclitaxel chemotherapy: A multicenter retrospective cohort study (PC-CURE-1)

Naohiro Okano et al. J Hepatobiliary Pancreat Sci. 2024 Nov.

Erratum in

Abstract

Background: The efficacy and safety of conversion surgery (CS) after FOLFIRINOX or gemcitabine plus nab-paclitaxel (GnP) chemotherapy in patients with initially unresectable pancreatic cancer (PC) remains unclear.

Methods: This multicenter retrospective cohort study enrolled patients, between 2014 and 2018, with initially locally advanced or metastatic PC who were considered candidates for CS following FOLFIRINOX or GnP chemotherapy. They were classified into surgery (207 patients [194 resection and 13 exploratory laparotomy only]) and continued chemotherapy (10 patients, control) groups. The primary endpoint was overall survival (OS) from the day of diagnosis of potentially curative resection on imaging studies, with an expected hazard ratio (HR) of 0.7.

Results: OS in the surgery group was longer than that in the control group (HR, 0.47; 95% confidence interval [CI]: 0.24-0.93). The median OS was 34.4 (95% CI: 27.9-43.4) and 19.8 (95% CI: 14.9-31.1) months in the surgery and control groups, respectively. The Clavien-Dindo grade ≥ IIIa postoperative complication and in-hospital mortality rates were 19.6% and 0.5%, respectively. Multivariate analysis revealed that preoperative chemotherapy duration was not associated with OS.

Conclusions: CS, following a favorable response to FOLFIRINOX or GnP chemotherapy, improved initially unresectable PC prognosis (specifically, OS), regardless of the chemotherapy duration.

Keywords: FOLFIRINOX; albumin‐bound paclitaxel; gemcitabine; pancreatic cancer; surgery.

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Conflict of interest statement

NO has received personal fees from AstraZeneca. UM has received grants from Taiho Pharmaceutical, AstraZeneca, MSD, Nihon Servier, Ono Pharmaceutical, Incyte Biosciences Japan, Chugai Pharmaceutical, Boehringer Ingelheim, J‐Pharma, Eisai, Novartis Pharma, Astellas Pharma, Delta‐Fly‐Pharma, Novocure, and Chiome Bioscience, and personal fees from Taiho Pharmaceutical. MO has received grants from Taiho Pharmaceutical. KY has received grants from Chugai Pharmaceutical. HY has received grants from Taiho Pharmaceutical, and the endowed course by Yakult Honsha. JF has received grants from MSD, J‐Pharma, Delta‐Fly‐Pharma, Taiho Pharmaceutical, Eisai, and AstraZeneca, and personal fees from Ono Pharmaceutical, Chugai Pharmaceutical, AstraZeneca, and Incyte Biosciences Japan. The other authors have no conflicts of interest to declare.

Figures

FIGURE 1
FIGURE 1
Patient flow chart.
FIGURE 2
FIGURE 2
Kaplan–Meier curves of overall survival from the day when initially unresectable pancreatic cancer was determined as potentially curative resection on images. CI, confidence interval.
FIGURE 3
FIGURE 3
(a) Kaplan–Meier curve for relapse‐free survival. CI, confidence interval; RFS, relapse‐free survival. (b) Kaplan–Meier curves for survival from laparotomy.
See this image and copyright information in PMC

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