Evidence map›Paper›PMID 34819998›Full record

ArticleTherapeutic advances in medical oncology2021

Liposomal irinotecan pre-emptive dose reduction in patients with pancreatic ductal adenocarcinoma: 667 patients' experience within a population-based study.

Tai-Jan Chiu, Yung-Yeh Su, Shih-Hung Yang, Chung-Pin Li, Li-Yuan Bai, Nai-Jung Chiang, Shih-Chang Chuang, Yan-Shen Shan, De-Chuan Chan, Li-Tzong Chen and 5 more

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Article in Therapeutic advances in medical oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
0.6field-weighted citation impact, top 28% of its field
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

7 citing papers in PubMed, 11 citations in OpenAlex.

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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

15 authors at 9 institutions in 1 country.

Tai-Jan ChiuDivision of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, Kaohsiung.
Yung-Yeh SuNational Institute of Cancer Research, National Health Research Institutes, Tainan.
Shih-Hung YangDepartment of Oncology, National Taiwan University Hospital, National Taiwan University, Taipei.
Chung-Pin LiDivision of Gastroenterology and Hepatology, Department of Medicine and Division of Clinical Skills Training, Taipei.
Li-Yuan BaiDivision of Hematology-Oncology, Department of Internal Medicine, China Medical University Hospital, China Medical University, Taichung.
Nai-Jung ChiangNational Institute of Cancer Research, National Health Research Institutes, Tainan.
Shih-Chang ChuangDivision of General and Digestive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung.
Yan-Shen ShanDivision of General Surgery, Department of Surgery, National Cheng Kung University Hospital, Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan.
De-Chuan ChanDivision of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei.
Li-Tzong ChenNational Institute of Cancer Research, National Health Research Institutes, Tainan.
Chia-Jui YenDivision of Hematology and Oncology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan.
Cheng-Ming PengDepartment of Surgery, Chung Shan Medical University Hospital, Chung Shan Medical University, Taichung.
Yen-Yang ChenDivision of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, Kaohsiung.
Jen-Shi ChenDivision of Hematology-Oncology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan.
Wen-Chi ChouDivision of Hematology-Oncology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, 5 Fu-Hsing Street, 333 Kwei-Shan Shiang, Taoyuan.ORCID https://orcid.org/0000-0002-0361-4548
Chang Gung University · TWNational Health Research Institutes · TWNational Cheng Kung University Hospital · TWChina Medical University · TWChung Shan Medical University Hospital · TWKaohsiung Medical University · TWNational Taiwan University Hospital · TWNational Yang Ming Chiao Tung University · TWTri-Service General Hospital · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLiposomal irinotecan (nal-IRI) plus 5-fluorouracil and leucovorin (5-FU/LV) is currently the standard second-line treatment for patients with pancreatic ductal adenocarcinoma (PDAC) after previous failed gemcitabine-based therapy. This population-based study aimed to evaluate the efficacy and safety of nal-IRI + 5-FU/LV and the association of pre-emptive nal-IRI dosing with treatment outcomes in patients with PDAC.

methodsWe retrospectively enrolled a total of 667 consecutive patients with PDAC who received nal-IRI plus 5-FU/LV treatment between August 2018 and November 2020 at 9 medical centers in Taiwan. Patients were allocated into groups according to pre-emptive nal-IRI dosing (⩾75%, 50-74%, <50%) for comparison of treatment efficacy and safety.

resultsThe median overall survival (OS) and time to treatment failure (TTF) were 5.9 months [95% confidence interval (CI), 5.3-6.5] and 2.8 months (95% CI, 2.6-3.0), respectively. The median OS was 6.5 months (95% CI, 5.7-6.7), 5.0 months (95% CI, 3.4-6.5), and 4.1 months (95% CI, 2.7-5.6), respectively, among the ⩾75%, 50-74%, and <50% pre-emptive nal-IRI dosing groups, whereas the median TTF of the three groups was 3.0 months (95% CI, 2.6-3.4), 2.6 months (95% CI, 2.3-2.9), and 1.9 months (95% CI, 1.6-2.2), respectively. Pre-emptive nal-IRI dosing <50% was an independent negative prognostic factor for OS and TTF in multivariate analyses. The most common severe adverse events were neutropenia (22.9%), anemia (21.1%), and hypokalemia (15.4%). Patients in the <50% pre-emptive nal-IRI dosing group had a significantly lower incidence of neutropenia and non-neutropenic infection than those in the other groups.

conclusionOur results support the use of nal-IRI + 5-FU/LV as standard clinical practice for treating patients with PDAC based on this large population-based study. Our findings encourage physicians to provide adequate doses of nal-IRI in order to achieve better outcomes without compromising safety profiles.

Indexed as

dose reductionliposomal irinotecanoutcomepancreatic cancertoxicity

Identifiers

PMID34819998
PMCPMC8606735
OpenAlexW3217193711

What OpenQuestion holds

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LicenceCC BY-NC
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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.