Evidence map›Paper›PMID 36504882›Full record

ArticleAmerican journal of cancer research2022

The impact of starting dose with or without subsequent dose escalation of liposomal irinotecan on treatment outcomes in patients with metastatic pancreatic ductal adenocarcinoma.

Nai-Jung Chiang, Yan-Shen Shan, Chung-Pin Li, Shih-Hung Yang, Yung-Yeh Su, Sz-Chi Chiu, Li-Yuan Bai, Shih-Chang Chuang, De-Chuan Chan, Chia-Jui Yen and 5 more

Open access · greenAbstract read
In one paragraph

Article in American journal of cancer research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.3field-weighted citation impact, top 39% 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

4 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. Article
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 1 institution in 1 country.

Nai-Jung ChiangDepartment of Oncology, Taipei Veterans General Hospital Taipei, Taiwan.
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, Taiwan.
Chung-Pin LiDepartment of Oncology, Taipei Veterans General Hospital Taipei, Taiwan.
Shih-Hung YangDepartment of Oncology, National Taiwan University Hospital and National Taiwan University Taipei, Taiwan.
Yung-Yeh SuNational Institute of Cancer Research, National Health Research Institutes Tainan, Taiwan.
Sz-Chi ChiuPharmaEngine, Inc. Taipei, Taiwan.
Li-Yuan BaiDivision of Hematology-Oncology, Department of Internal Medicine, China Medical University Hospital and China Medical University Taichung, Taiwan.
Shih-Chang ChuangDivision of General and Digestive Surgery, Department of Surgery, Kaohsiung Medical University Hospital and Kaohsiung Medical University Kaohsiung, Taiwan.
De-Chuan ChanDivision of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center Taipei, Taiwan.
Chia-Jui YenDivision of Hematology and Oncology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University Tainan, Taiwan.
Cheng-Ming PengDepartment of Surgery, Chung Shan Medical University Hospital and Chung Shan Medical University Taichung, Taiwan.
Tai-Jan ChiuDivision of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University Kaohsiung, Taiwan.
Yen-Yang ChenDivision of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University Kaohsiung, Taiwan.
Jen-Shi ChenDivision of Hematology-Oncology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital and College of Medicine, Chang Gung University Taoyuan, Taiwan.
Wen-Chi ChouDivision of Hematology-Oncology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital and College of Medicine, Chang Gung University Taoyuan, Taiwan.
National Yang Ming Chiao Tung University · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Liposomal irinotecan (nal-IRI) plus 5-fluorouracil and leucovorin (5-FU/LV) improves survival in patients with pancreatic ductal adenocarcinoma (PDAC) after progression to gemcitabine-based therapy. Few studies have examined whether the starting dose and dose escalation of nal-IRI in subsequent treatment cycles may influence patient outcomes and toxicity profiles. A total of 667 patients who received nal-IRI + 5-FU/LV for PDAC treatment between August 2018 and November 2020 at nine medical centers in Taiwan were included and retrospectively analyzed. Patients were allocated to the standard starting dose (SD), reduced starting dose (RD) without escalation, and RD with escalation of nal-IRI groups for comparison of survival outcome and safety. Propensity score matching (PSM) was performed to adjust for possible confounding variables. Nal-IRI was prescribed at SD, RD without escalation, and RD with escalation in 465 (69.7%), 147 (22.0), and 55 (8.2%), respectively. RD with escalation patients had significantly longer treatment cycles (6, range 2-25) than SD (5, range 1-42, P<0.001) and RD without escalation patients (4, range 1-26, P<0.001). The median overall survival (OS) of the patients were as follows: SD, 6.2 months (95% confidence interval [CI], 5.7-6.7); RD with escalation, 7.6 months (95% CI, 6.1-9.2); and RD without escalation, 3.6 months (95% CI, 2.6-4.5). After PSM to adjust for potential confounders, RD without escalation patients still had the poorest OS compared to the other two groups (P<0.001), while the OS difference between SD and RD with escalation patients was insignificant (P=0.10). SD patients had higher incidences of ≥ grade 3 neutropenia and febrile neutropenia than the other two groups. Administering nal-IRI at RD followed by dose escalation in subsequent treatment cycles is safe and does not compromise survival outcomes in selected patients with PDAC receiving nal-IRI plus 5-FU/LV.

Indexed as

dose escalationdrug compliancenanoliposomal irinotecanPre-emptive dose reductiontolerance

Identifiers

PMID36504882
PMCPMC9729898
OpenAlexW4311290253

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.