Evidence map›Paper›PMID 41795872›Full record

ArticleCancer science2026

FOLFIRINOX vs. Gemcitabine/Nab-Paclitaxel for Pancreatic Cancer by BRCA2 and TMB Status: A Japanese C-CAT Database Study.

Kazuyuki Mizuno, Takuya Ishikawa, Takanori Ito, Yuko Takano, Osamu Maeda, Hiroki Kawashima, Yuichi Ando

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer science, 2026. 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. Review
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

7 authors.

Kazuyuki MizunoDepartment of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Aichi, Japan.ORCID https://orcid.org/0000-0001-8059-8433
Takuya IshikawaDepartment of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Takanori ItoDepartment of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Yuko TakanoDepartment of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Aichi, Japan.ORCID https://orcid.org/0000-0002-3753-7683
Osamu MaedaDepartment of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Aichi, Japan.ORCID https://orcid.org/0000-0003-4700-6541
Hiroki KawashimaDepartment of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Yuichi AndoDepartment of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Aichi, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The clinical impact of BRCA2 variants and tumor mutational burden (TMB) on first-line regimen selection-FOLFIRINOX (FFX) versus gemcitabine plus nab-paclitaxel (GnP)-for pancreatic ductal adenocarcinoma (PDAC) remains unclear. Using the Center for Cancer Genomics and Advanced Therapeutics (C-CAT) database, we analyzed patients with unresectable or recurrent PDAC treated with first-line FFX or GnP. Overall survival (OS) and time to treatment failure (TTF) were compared, stratified by BRCA2 pathogenic variants (PVs) and TMB status. A total of 4356 patients were included. In the overall population, GnP was associated with superior adjusted OS compared with FFX (adjusted hazard ratio [HR] 0.90, p = 0.015), while TTF was comparable. In patients with BRCA2 PVs (3.3%), FFX demonstrated a significantly higher objective response rate (66.7% vs. 33.3%) and longer TTF compared with GnP. However, OS in patients with BRCA2 PVs was comparable between the two regimens (HR 1.11, p = 0.665). Among patients with BRCA2 PVs treated with GnP, OS was numerically longer with second-line FFX than with nal-IRI/5-FU/leucovorin (HR 0.51; p = 0.119). In patients without BRCA2 PVs, OS was longer with GnP. TMB-high status (2.9%) predicted significantly longer OS regardless of the first-line regimen (HR 0.64, p < 0.001). In conclusion, GnP was associated with superior adjusted OS in the overall population. In BRCA2 PV tumors, greater tumor shrinkage with first-line FFX did not translate into longer OS, underscoring the importance of sequencing strategies that ensure timely exposure to platinum-based therapy. TMB-high tumors may benefit from timely access to immunotherapy.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsBRCA2 ProteinCarcinoma, Pancreatic DuctalPancreatic NeoplasmsAgedAged, 80 and overAlbuminsBiomarkers, TumorDatabases, FactualDeoxycytidineFemaleFluorouracilGemcitabineHumansIrinotecanJapan130-nm albumin-bound paclitaxelAlbuminsBiomarkers, TumorBRCA2 ProteinBRCA2 protein, humanDeoxycytidineFluorouracilfolfirinoxGemcitabineIrinotecanLeucovorinOxaliplatinPaclitaxelBRCA2FOLFIRINOXgemcitabine plus nab‐paclitaxelpancreatic ductal adenocarcinomatumor mutational burden

Identifiers

PMID41795872
PMCPMC13134512

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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.