@article{Liu2024, 
author = {Yuxiao Liu and Xiaofan Guo and Peijun Xu and Yuning Song and Jing Huang and Xingyun Chen and Wenbo Zhu and Jihui Hao and Song Gao},
title = {Clinical outcomes of second-line chemotherapy in patients with advanced pancreatic adenocarcinoma: a real-world study},
year = {2024},
journal = {Cancer Biology & Medicine},
volume = {21},
number = {9},
pages = {799-812},
keywords = {gemcitabine, real-world study, 5-fluorouracil, Second-line chemotherapy, advanced pancreatic adenocarcinoma},
url = {https://www.sciopen.com/article/10.20892/j.issn.2095-3941.2024.0036},
doi = {10.20892/j.issn.2095-3941.2024.0036},
abstract = {ObjectiveLittle progress has been made in recent years using first-line chemotherapy, including gemcitabine combined with nab-paclitaxel, FOLFIRINOX, and NALIRIFOX, for advanced pancreatic adenocarcinoma (APC). In addition, the optimal second-line chemotherapy regimen has not been determined. This study aimed to compare the effectiveness of different types of second-line chemotherapy for APC.MethodsPatients with APC who received first-line treatment from January 2008 to January 2021 were considered eligible for this retrospective analysis. The primary and secondary endpoints were overall survival (OS) and progression-free survival (PFS), respectively.ResultsFour hundred and thirty-seven and 617 patients were treated with 5-fluorouracil- and gemcitabine-based chemotherapy as first-line treatment, respectively. Demographic and clinical features, except age and liver metastasis, were comparable between the two groups (P < 0.05). The median OS was 8.8 and 7.8 months in patients who received a 5-fluorouracil- and gemcitabine-based combined regimen for first-line therapy, respectively (HR = 1.244, 95% CI = 1.090–1.419; P < 0.001). The median OS was 5.6 and 1.9 months in patients who received second-line chemotherapy and supportive care, respectively (HR = 0.766, 95% CI = 0.677–0.867; P < 0.001). The median PFS was not significantly differently between gemcitabine or 5-fluorouracil monotherapy and combination therapy.ConclusionsA 5-fluorouracil- or gemcitabine-based combined regimen was shown to be as effective as a single 5-fluorouracil or gemcitabine regimen as second-line therapy for patients with APC.}
}