Evidence map›Paper›PMID 31724340›Full record

ArticleCancer medicine2020

Real-world outcomes of FOLFIRINOX vs gemcitabine and nab-paclitaxel in advanced pancreatic cancer: A population-based propensity score-weighted analysis.

Kelvin K W Chan, Helen Guo, Sierra Cheng, Jaclyn M Beca, Ruby Redmond-Misner, Wanrudee Isaranuwatchai, Lucy Qiao, Craig Earle, Scott R Berry, James J Biagi and 10 more

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
51citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

51 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Kelvin K W ChanCancer Care Ontario, Toronto, ON, Canada.ORCID 0000-0002-2501-3057
Helen GuoCancer Care Ontario, Toronto, ON, Canada.
Sierra ChengSunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada.ORCID 0000-0002-4594-5337
Jaclyn M BecaCanadian Centre for Applied Research in Cancer Control, Toronto, ON, Canada.
Ruby Redmond-MisnerPharmacoeconomics Research Unit, Cancer Care Ontario, Toronto, ON, Canada.
Wanrudee IsaranuwatchaiCanadian Centre for Applied Research in Cancer Control, Toronto, ON, Canada.
Lucy QiaoCancer Care Ontario, Toronto, ON, Canada.
Craig EarleSunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada.
Scott R BerrySunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada.
James J BiagiCancer Centre of Southeastern Ontario, Kingston, ON, Canada.
Stephen WelchLondon Regional Cancer Program, London, ON, Canada.
Brandon M MeyersHamilton Health Sciences Centre, Hamilton, ON, Canada.
Nicole MittmannCancer Care Ontario, Toronto, ON, Canada.
Natalie CoburnSunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada.
Jessica AriasCancer Care Ontario, Toronto, ON, Canada.
Deborah SchwartzCancer Care Ontario, Toronto, ON, Canada.
Wei F DaiCancer Care Ontario, Toronto, ON, Canada.
Scott GavuraCancer Care Ontario, Toronto, ON, Canada.
Robin McLeodCancer Care Ontario, Toronto, ON, Canada.
Erin D KennedyCancer Care Ontario, Toronto, ON, Canada.ORCID 0000-0003-0707-5294

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn Ontario, FOLFIRINOX (FFX) and gemcitabine + nab-paclitaxel (GnP) have been publicly funded for first-line unresectable locally advanced pancreatic cancer (uLAPC) or metastatic pancreatic cancer (mPC) since April 2015. We examined the real-world effectiveness and safety of FFX vs GnP for advanced pancreatic cancer, and in uLAPC and mPC.

methodsPatients receiving first-line FFX or GnP from April 2015 to March 2017 were identified in the New Drug Funding Program database. Baseline characteristics and outcomes were obtained through the Ontario Cancer Registry and other population-based databases. Overall survival (OS) was assessed using Kaplan-Meier and weighted Cox proportional hazard models, weighted by the inverse propensity score adjusting for baseline characteristics. Weighted odds ratio (OR) for hospitalization and emergency department visits (EDV) were estimated from weighted logistic regression models.

resultsFor 1130 patients (632 FFX, 498 GnP), crude median OS was 9.6 and 6.1 months for FFX and GnP, respectively. Weighted OS was improved for FFX vs GnP (HR = 0.77, 0.70-0.85). Less frequent EDV and hospitalization were observed in FFX (EDV: 67.8%; Hospitalization: 49.2%) than GnP (EDV: 77.7%; Hospitalization: 59.3%). More frequent febrile neutropenia-related hospitalization was observed in FFX (5.8%) than GnP (3.3%). Risk of EDV and hospitalization were significantly lower for FFX vs GnP (EDV: OR = 0.68, P = .0001; Hospitalization: OR = 0.76, P = .002), whereas the risk of febrile neutropenia-related hospitalization was significantly higher (OR = 2.12, P = .001). Outcomes for uLAPC and mPC were similar.

conclusionIn the real world, FFX had longer OS, less frequent all-cause EDV and all-cause hospitalization, but more febrile neutropenia-related hospitalization compared to GnP.

Indexed as

AgedAlbuminsAntineoplastic Combined Chemotherapy ProtocolsChemotherapy-Induced Febrile NeutropeniaDeoxycytidineEmergency Service, HospitalFemaleFluorouracilFollow-Up StudiesGemcitabineHospitalizationHumansIrinotecanKaplan-Meier EstimateLeucovorinMale130-nm albumin-bound paclitaxelAlbuminsDeoxycytidineFluorouracilfolfirinoxGemcitabineIrinotecanLeucovorinOxaliplatinPaclitaxelFOLFIRINOXgemcitabineoutcomespancreatic cancerreal-world evidence

Identifiers

PMID31724340
PMCPMC6943167

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.