Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Aug;30(8):1610-1620.
doi: 10.1007/s10147-025-02796-0. Epub 2025 Jun 11.

Impact of second-line combination chemotherapy on post-progression survival in metastatic and recurrent pancreatic cancer

Takafumi Mie  1 , Masato Ozaka  2 , Takeshi Okamoto  1 , Tsuyoshi Takeda  1 , Yoichiro Sato  1 , Tatsuki Hirai  1 , Takahiro Ishitsuka  1 , Yuri Maegawa  1 , Takaaki Furukawa  1 , Yukari Suzuki  1 , Takashi Sasaki  1 , Naoki Sasahira  1
Affiliations

Impact of second-line combination chemotherapy on post-progression survival in metastatic and recurrent pancreatic cancer

Takafumi Mie et al. Int J Clin Oncol. 2025 Aug.

Abstract

Background: This study aimed to evaluate the efficacy of the second-line combination chemotherapy (CC) for patients with metastatic or recurrent pancreatic cancer.

Methods: We retrospectively analyzed consecutive patients with metastatic or recurrent pancreatic cancer, who received second-line chemotherapy after disease progression on first-line modified FOLFIRINOX (mFFX) or gemcitabine with nab-paclitaxel (GnP) between January 2014 and March 2023 at our hospital. Overall survival (OS), progression-free survival (PFS), and post-progression survival (PPS) were compared between first-line mFFX and GnP. In addition, OS, PFS, and PPS for second-line treatment with CC and single-agent chemotherapy (SAC) were compared using propensity score matching (PSM).

Results: 457 patients (mFFX/GnP: 122/335) were included. Median OS and PPS of mFFX and GnP were 15.5 months vs. 15.0 months (p = 0.73) and 7.7 months vs. 7.2 months (p = 0.37), respectively. After PSM, median OS and median PPS were significantly longer in the CC group than in the SAC group (OS: 16.3 months vs. 12.8 months, p < 0.01; PPS: 8.0 months vs. 5.5 months, p < 0.01). There was no difference in first-line PFS between the two groups (7.1 months vs. 6.4 months, p = 0.74). Performance status at the beginning of first-line treatment, and carbohydrate antigen 19-9 level, Glasgow prognostic score at the end of first-line treatment, and second-line CC were independently associated with OS.

Conclusion: Second-line CC achieved longer PPS and OS than SAC. To improve OS, it was important to receive second-line CC.

Keywords: Chemotherapy; FOLFIRINOX; Gemcitabine with nab-paclitaxel; Pancreatic cancer; Post-progression survival.

PubMed Disclaimer

Conflict of interest statement

Declarations. Conflict of interest: The authors declare that they have no conflict of interest.

Similar articles

See all similar articles

References

    1. Ilic M, Ilic I (2016) Epidemiology of pancreatic cancer. World J Gastroenterol 22(44):9694–9705. https://doi.org/10.3748/wjg.v22.i44.9694 - DOI - PubMed - PMC
    1. Conroy T, Desseigne F, Ychou M et al (2011) FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med 364(19):1817–1825. https://doi.org/10.1056/NEJMoa1011923 - DOI - PubMed
    1. Von Hoff DD, Ervin T, Arena FP et al (2013) Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine. N Engl J Med 369(18):1691–1703. https://doi.org/10.1056/NEJMoa1304369 - DOI
    1. Ozaka M, Ishii H, Sato T et al (2018) A phase II study of modified FOLFIRINOX for chemotherapy-naive patients with metastatic pancreatic cancer. Cancer Chemother Pharmacol 81(6):1017–1023. https://doi.org/10.1007/s00280-018-3577-9 - DOI - PubMed
    1. Mie T, Sasaki T, Takeda T et al (2021) Comparison of treatment outcomes between gemcitabine with nab-paclitaxel and modified FOLFIRINOX for first-line chemotherapy in metastatic and recurrent pancreatic cancer: propensity score matching. Pancreas 50(4):595–601. https://doi.org/10.1097/MPA.0000000000001801 - DOI - PubMed

MeSH terms

LinkOut - more resources