Evidence map›Paper›PMID 38951245›Full record

Trial reportJournal of cancer research and clinical oncology2024

Sequential therapy of refractory metastatic pancreatic cancer with 5-FU/LV/irinotecan (FOLFIRI) vs. 5-FU/LV/oxaliplatin (OFF). The PANTHEON trial (AIO PAK 0116).

Dominik Paul Modest, Volker Heinemann, Philipp Schütt, Stefan Angermeier, Mike Haberkorn, Oliver Waidmann, Ullrich Graeven, Kai Wille, Volker Kunzmann, Larissa Henze and 10 more

Abstract readRandomized Controlled TrialMulticenter StudyEquivalence Trial
In one paragraph

Trial report in Journal of cancer research and clinical oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. 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

20 authors.

Dominik Paul ModestCharité - Universitätsmedizin Berlin, Department of Hematology, Oncology, and Cancer Immunology, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany. dominik.modest@charite.de.
Volker HeinemannGerman Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg, Germany.
Philipp SchüttPractice of Hematology and Oncology, Gütersloh, Germany.
Stefan AngermeierDepartment of Gastroenterology, Hematology and Oncology, Hospital Ludwigsburg, Ludwigsburg, Germany.
Mike HaberkornÜBAG MVZ Dr. Vehling-Kaiser GmbH, Landshut, Germany.
Oliver WaidmannCentrum für Hämatologie und Onkologie Bethanien, Im Prüfling 17-19, 60389, Frankfurt, Germany.
Ullrich GraevenDepartment of Hematology, Oncology and Gastroenterology, Klinken Maria Hilf GmbH, Mönchengladbach, Germany.
Kai WilleUniversity Clinic for Haematology, Oncology, Haemostaseology and Palliative Care, Johannes Wesling Medical Center Minden, University of Bochum, Bochum, Germany.
Volker KunzmannMedical Clinic and Polyclinic II - IOT, University Hospital Würzburg, Würzburg, Germany.
Larissa HenzeDepartment of Medicine, Clinic III, Hematology, Oncology, Palliative Medicine, Rostock University Medical Center, Rostock, Germany.
Christian ConstantinDepartment for Oncology and Hematology, Clinical Center Lippe-Lemgo, Lemgo, Germany.
Maike de WitDepartment for Internal Medicine-Hematology and Oncology, VIVANTES Hospital Neukölln, Berlin, Germany.
Claudio DenzlingerClinic for Internal Medicine 3, Marienhospital, Stuttgart, Germany.
Alexej BallhausenCharité - Universitätsmedizin Berlin, Department of Hematology, Oncology, and Cancer Immunology, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Annika KurreckCharité - Universitätsmedizin Berlin, Department of Hematology, Oncology, and Cancer Immunology, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Ivan JelasCharité - Universitätsmedizin Berlin, Department of Hematology, Oncology, and Cancer Immunology, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Annabel Helga Sophie AligCharité - Universitätsmedizin Berlin, Department of Hematology, Oncology, and Cancer Immunology, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Arndt StahlerCharité - Universitätsmedizin Berlin, Department of Hematology, Oncology, and Cancer Immunology, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Sebastian StintzingCharité - Universitätsmedizin Berlin, Department of Hematology, Oncology, and Cancer Immunology, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Helmut OettlePractice for Internal Medicine, Joint Practice and Day Clinic, Friedrichshafen, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIn patients with metastatic pancreatic cancer, after failure of gemcitabine/nab-paclitaxel, this trial compares the efficacy of second-line therapy with FOLFIRI vs. OFF (1:1 randomisation) with cross-over to the vice-versa regimen as third-line therapy. PATIENTS AND

methodsThe primary endpoint was PFS (progression-free survival: time from randomization until progression or death) of second-line therapy. The trial aimed to demonstrate non-inferiority of FOLFIRI vs OFF (non-inferiority margin of a hazard ratio (HR) of 1.5, power of 80% and a significance level of 5%, 196 events needed). Secondary endpoints included overall survival (OS), progression-free survival of third-line therapy and safety. The trial is registered with EudraCT Nr. 2016-004640-11.

resultsThe trial was terminated with 60 evaluable (37 with FOLFIRI, 23 with OFF) patients due to insufficient recruitment. PFS of second-line therapy was 2.4 (95% CI 2.3-2.6) months with FOLFIRI vs 2.4 (95% CI 2.2-2.7) months with OFF (HR: 0.80, 95% CI 0.45-1.42, P = 0.43). OS was comparable between the arms (HR: 0.95, 95% CI 0.54-1.66), P = 0.84). Only 4 out of 28 (14%) patients receiving third-line therapy achieved a disease control (partial remission or stable disease). Both second-line regimens were well tolerated without new or unexpected safety signals being observed.

conclusionThe exploratory analysis of this early terminated trial suggests that FOLFIRI and OFF have similar efficacy ant toxicity as second-line therapy of PDAC after failure of gemcitabine/nab-paclitaxel. Third-line therapy regardless of regimen does not provide satisfactory efficacy in this sequential treatment algorithm.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsFluorouracilIrinotecanLeucovorinOxaliplatinPancreatic NeoplasmsAdultAgedCamptothecinCross-Over StudiesFemaleHumansMaleMiddle AgedProgression-Free SurvivalCamptothecinFluorouracilIrinotecanLeucovorinOxaliplatinChemotherapyFluoropyrimidineFOLFIRIMetastaticOxaliplatinPancreatic cancer

Identifiers

PMID38951245
PMCPMC11217046

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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.