Evidence map›Paper›PMID 39614927›Full record

ArticleJournal of gastroenterology2025

Efficacy of liposomal irinotecan + 5-FU/LV vs. S-1 in gemcitabine-refractory metastatic pancreatic cancer: a real-world study using inverse probability of treatment weighting.

Hiroshi Imaoka, Masafumi Ikeda, Satoshi Kobayashi, Akihiro Ohba, Masayuki Ueno, Yuko Suzuki, Hidetaka Tsumura, Nana Kimura, Shinya Kawaguchi, Yasuyuki Kawamoto and 28 more

Erratum issuedAbstract readMulticenter StudyComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

38 authors.

Hiroshi ImaokaDepartment of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Japan. hiimaoka@east.ncc.go.jp.ORCID 0000-0003-0584-0095
Masafumi IkedaDepartment of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
Satoshi KobayashiDepartment of Gastroenterology, Kanagawa Cancer Center, Yokohama, Japan.
Akihiro OhbaDepartment of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan.
Masayuki UenoDepartment of Gastroenterology and Hepatology, Kurashiki Central Hospital, Kurashiki, Japan.
Yuko SuzukiDepartment of Gastroenterology, Saitama Cancer Center, Saitama, Japan.
Hidetaka TsumuraDepartment of Gastroenterological Oncology, Hyogo Cancer Center, Akashi, Japan.
Nana KimuraDepartment of Surgery and Science, Faculty of Medicine, University of Toyama, Toyama, Japan.
Shinya KawaguchiDepartment of Gastroenterology, Shizuoka General Hospital, Shizuoka, Japan.
Yasuyuki KawamotoDivision of Cancer Center, Hokkaido University Hospital, Sapporo, Japan.
Kohei NakachiDepartment of Medical Oncology, Tochigi Cancer Center, Utsunomiya, Japan.
Kunihiro TsujiDepartment of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan.
Noritoshi KobayashiGastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan.
Reiko AshidaSecond Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
Naohiro OkanoDepartment of Medical Oncology, Kyorin University Faculty of Medicine, Tokyo, Japan.
Kumiko UmemotoDepartment of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, Japan.
Gou MurohisaDepartment of Gastroenterology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.
Ayumu HosokawaDepartment of Clinical Oncology, University of Miyazaki Hospital, Miyazaki, Japan.
Akinori AsagiDepartment of Gastrointestinal Medical Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan.
Hiroko NebikiDepartment of Gastroenterology, Osaka City General Hospital, Osaka, Japan.
Rei SuzukiDepartment of Gastroenterology, Fukushima Medical University, Fukushima, Japan.
Takeshi TerashimaDepartment of Gastroenterology, Kanazawa University Hospital, Kanazawa, Japan.
Ryusuke ShibataDigestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Kazuhito KawataHepatology Division, Department of Internal Medicine II, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Toshifumi DoiDepartment of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Hiroshi OhyamaDepartment of Gastroenterology, Chiba University, Chiba, Japan.
Yohei KitanoDivision of Gastroenterology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan.
Kazuhiko ShiojiDepartment of Internal Medicine, Niigata Cancer Center Hospital, Niigata, Japan.
Hiroyuki OkuyamaDepartment of Medical Oncology, Kagawa University Hospital, Miki, Japan.
Atsushi NaganumaDepartment of Gastroenterology, National Hospital Organization Takasaki General Medical Center, Gunma, Japan.
Yuji NegoroDepartment of Oncological Medicine, Kochi Health Sciences Center, Kochi, Japan.
Yasunari SakamotoDepartment of Gastroenterology and Hepatology, International University of Health and Welfare Atami Hospital, Shizuoka, Japan.
Satoshi ShimizuDepartment of Gastroenterology, Saitama Cancer Center, Saitama, Japan.
Chigusa MorizaneDepartment of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan.
Makoto UenoDepartment of Gastroenterology, Kanagawa Cancer Center, Yokohama, Japan.
Junji FuruseDepartment of Gastroenterology, Kanagawa Cancer Center, Yokohama, Japan.
Hiroaki NaganoDepartment of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan.
Japan Oncology Network in Hepatobiliary and Pancreas

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundS-1 monotherapy had previously been widely used as a second-line treatment for pancreatic cancer (PC) after gemcitabine-based chemotherapy mainly in Japan. Based on the results of the NAPOLI-1 trial, the recommended second-line therapy is now liposomal irinotecan plus fluorouracil/folinic acid (nal-IRI + 5-FU/LV). However, there have been no studies comparing nal-IRI + 5-FU/LV therapy with S-1 monotherapy.

methodsThe main objective of this study was to compare overall survival (OS) in patients treated with nal-IRI + 5-FU/LV and those treated with S-1 monotherapy as second-line treatments, using the inverse probability of treatment weighting (IPTW) method. This study was conducted in 31 institutions participating in Japan Oncology Network in Hepatobiliary and Pancreas. To minimize potential biases due to the retrospective design, IPTW analysis was performed with multiple imputation, and imputed IPTW-adjusted hazard ratios and corresponding 95% confidence intervals (CIs) were estimated using a Cox proportional hazards model and combined into pooled estimates.

resultsA total of 463 metastatic PC patients were enrolled in this study (257 in the S-1 monotherapy group and 206 in the nal-IRI + 5-FU/LV group). The median OS was 7.50 months (95% CI 4.18-12.69 months) in the nal-IRI + 5-FU/LV group and 5.72 months (95% CI 2.76-10.79 months) in the S-1 monotherapy group. In the IPTW-adjusted Cox proportional hazards model, nal-IRI + 5-FU/LV was associated with a significant OS benefit (pooled IPTW-adjusted hazard ratio, 0.779; 95% CI 0.399-0.941; p = 0.025).

conclusionThese findings support the use of nal-IRI + 5-FU/LV as standard second-line treatment for PC patients after gemcitabine-based chemotherapy.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsPancreatic NeoplasmsAdultAgedAged, 80 and overAntimetabolites, AntineoplasticCamptothecinDeoxycytidineDrug CombinationsFemaleFluorouracilGemcitabineHumansIrinotecanJapanLeucovorinAntimetabolites, AntineoplasticCamptothecinDeoxycytidineDrug CombinationsFluorouracilGemcitabineIrinotecanLeucovorinLiposomesOxonic AcidS 1 (combination)TegafurLiposomal irinotecanPancreatic cancerS-1Second line

Identifiers

PMID39614927
PMCPMC11880175

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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.