26vzmnrw138
10.3205/26vzmnrw138
urn:nbn:de:0183-26vzmnrw1386
Meeting Abstract
NALIRIFOX and other nal-IRI based regimen as sequential therapy after FOLFIRINOX in unresectable pancreatic cancer
Im
Im
N. G.
NG
Uniklinik Köln, Klinik für Gastroenterologie und Hepatologie, Köln, Deutschland
author
Stegmann
Stegmann
S.
S
Uniklinik Köln, Klinik für Gastroenterologie und Hepatologie, Köln, Deutschland
author
Hollnberger
Hollnberger
J.
J
Uniklinik Köln, Klinik für Gastroenterologie und Hepatologie, Köln, Deutschland
author
Meyer zu Schwabedissen
Meyer zu Schwabedissen
A.
A
Uniklinik Köln, Klinik für Gastroenterologie und Hepatologie, Köln, Deutschland
author
Bartz
Bartz
C.
C
Uniklinik Köln, Institut für Diagnostische und Interventionelle Radiologie, Köln, Deutschland
author
Persigehl
Persigehl
T.
T
Uniklinik Köln, Institut für Diagnostische und Interventionelle Radiologie, Köln, Deutschland
author
Neumann-Haefelin
Neumann-Haefelin
C.
C
Uniklinik Köln, Klinik für Gastroenterologie und Hepatologie, Köln, Deutschland
author
Waldschmidt
Waldschmidt
D. T.
DT
Uniklinik Köln, Klinik für Gastroenterologie und Hepatologie, Köln, Deutschland
author
German Medical Science GMS Publishing House
Düsseldorf
610
20260618
engl
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung).
M0644
138
Niederrheinisch-Westfälische Gesellschaft für Chirurgie
Gesellschaft für Gastroenterologie in Nordrhein-Westfalen e.V.
192. Jahrestagung der Niederrheinisch-Westfälischen Gesellschaft für Chirurgie, 34. Jahrestagung der Gesellschaft für Gastroenterologie
Viszeralmedizin NRW 2026
Gastroenterologie
Dortmund
20260618
20260619
138
TextBackground and objective: Chemotherapy with 5-fluoruracil (5-FU)/folinic acid (FA), irinotecan (IRI) and oxaliplatin (OX) (FOLFIRINOX) is a standard first line treatment in advanced pancreatic cancer. Recently, an alternative regimen with nanoliposomal irinotecan (nal-IRI) (NALIRIFOX) has shown benefit over gemcitabine and nab-paclitaxel (GN) in treatment-naïve metastatic patients (pts). Accordingly, clinical practice guidelines have incorporated both, FOLFIRINOX and NALIRIFOX, as possible first line therapeutic options. In clinical practice, it is difficult to choose one regimen over the other, as there is neither a direct comparison nor any data analyzing the sequential use of NALIRIFOX and FOLFIRINOX.Method: In this retrospective study, pancreatic cancer pts who were recommended a nal-IRI containing therapy by a multidisciplinary tumor board of a tertiary care center in Germany were screened between 01/2023 and 06/2025. Cases were included if they had a history of FOLFIRINOX treatment and at least one cycle of a nal-IRI based chemotherapy regimen. Stagings were performed after 1-4 months. The primary outcomes of interest were progression free survival (PFS) and overall survival (OS). Exploratory outcomes included disease control and secondary resectability rate.Result: A total of 21 pts with histologically proven pancreatic cancer were included in the study. Prior to nal-IRI, pts received a median of 7 cycles of FOLFIRINOX. Other frequent therapies that were applied before or after FOLFIRINOX were GN (n=10) and surgery (n=9). Following the multidisciplinary tumor board recommendation, 12 pts received NALIRIFOX and 9 patients received other nal-IRI based regimen (nal-IRI with 5-FU/FA (n=7) or capecitabine (n=2)) with a median of 6 cycles and a median follow-up time of 14.5 months at the time of analysis.Median PFS was 10.8 months, median OS was 14.2 months. The disease control rate was 80.95%.7 patients were locally advanced and received nal-IRI with neoadjuvant intention after FOLFIRINOX failed to achieve resectability. Of those, 3 patients achieved resectability with nal-IRI, the remaining 4 patients changed regimen before progression.Summary: NALIRIFOX and nal-IRI based regimen as sequential therapy after FOLFIRINOX show promising PFS and OS and may therefore be a therapeutic option option in metastasized or neoadjuvant settings. Despite the similarity of the regimen, sequential therapy achieved disease control in the majority and secondary resectability in some of the patients.
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