ReviewESMO gastrointestinal oncology2025
Long-term survival in patients with pancreatic cancer treated with second-line liposomal irinotecan plus 5-fluorouracil/leucovorin: observations from Korea, Italy, and Germany.
Review in ESMO gastrointestinal oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
7 authors.
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Abstract
Pancreatic cancer (PAC) is an aggressive disease with poor clinical outcomes. Liposomal irinotecan in combination with 5-fluorouracil and leucovorin (nal-IRI+5-FU/LV) is the only approved therapy for metastatic PAC following gemcitabine-based therapy, based on the survival benefit demonstrated in the phase III NAPOLI-1 trial. Factors associated with long-term survival in this trial included age ≤65 years, Karnofsky performance status (KPS) ≥90, neutrophil-to-lymphocyte (N/L) ratio ≤5, carbohydrate antigen (CA) 19-9 <59-times the upper limit of normal (ULN), and no liver metastases. Using real-world data from studies conducted in Korea, Italy, and Germany, this review aims to assess the suitability of prognostic factors identified in the NAPOLI-1 trial nomogram. In these real-world studies, a high CA19-9 level and a low N/L ratio were associated with long-term survival in patients treated with nal-IRI+5-FU/LV. The impact of albumin levels, body mass index (BMI), liver metastasis, and KPS on survival identified from the NAPOLI-1 trial was confirmed in some real-world analyses but not consistently. Factors such as patient age and number of previous lines of treatment that were not identified in the NAPOLI-1 nomogram may be associated with long-term survival with nal-IRI+5-FU/LV in the real-world. In conclusion, this review has shown that while prognostic factors are useful for patient stratification, their predictive value on the efficacy of nal-IRI+5-FU/LV is low, thus this treatment may also result in long-term survival in patients with apparently unfavorable characteristics.
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