Evidence map›Paper›PMID 41915263›Full record

SynthesisClinical & experimental metastasis2026

Nal-IRI (liposomal irinotecan) plus 5-fluorouracil and leucovorin versus 5-fluorouracil for metastatic pancreatic ductal adenocarcinoma following gemcitabine-based therapy. A systematic review and meta-analysis of randomized controlled trials.

Elsa Vitale, Alessandro Rizzo, Lorenza Maistrello, Angela Monica Sciacovelli, Raffaele De Luca, Anna Albano, Annarita Fanizzi, Raffaella Massafra, Claudio Lotesoriere, Gennaro Gadaleta-Caldarola and 2 more

Abstract readMeta-AnalysisSystematic Review
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In one paragraph

Synthesis in Clinical & experimental metastasis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

12 authors.

Elsa Vitale *IRCCS Istituto Tumori "Giovanni Paolo II", Viale Orazio Flacco 65, 70124, Bari, Italy.
Alessandro Rizzo *IRCCS Istituto Tumori "Giovanni Paolo II", Viale Orazio Flacco 65, 70124, Bari, Italy. rizzo.alessandro179@gmail.com.
Lorenza MaistrelloIRCCS San Camillo Hospital, Venice, Italy.
Angela Monica SciacovelliIRCCS Istituto Tumori "Giovanni Paolo II", Viale Orazio Flacco 65, 70124, Bari, Italy.
Raffaele De LucaDepartment of Surgical Oncology, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy.
Anna AlbanoSSD Tumori Rari e Melanoma, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy.
Annarita FanizziLaboratorio di Bioinformatica e Biostatistica, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy.
Raffaella MassafraLaboratorio di Bioinformatica e Biostatistica, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy.
Claudio LotesoriereMedical Oncology Unit, IRCCS Saverio de Bellis Hospital, Castellana Grotte, Italy.
Gennaro Gadaleta-CaldarolaOncology Unit, "Mons. A. R. Dimiccoli" Hospital, 70051, Barletta, Italy.
Salvatore PiscontiMedical Oncology Division, "San Giuseppe Moscati" Hospital, Taranto, Italy.
Oronzo BrunettiTDM, IRCCS Istituto Tumori "Giovanni Paolo II", Viale Orazio Flacco 65, 70124, Bari, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPancreatic cancer has a poor prognosis. The present systematic review and meta-analysis evaluated progression free survival (PFS) and overall survival (OS) after gemcitabine-based therapy nal-IRI (liposomal irinotecan) plus 5-fluorouracil and leucovorin versus 5-fluorouracil for metastatic pancreatic ductal adenocarcinoma (PDAC) patients.

methodsThe present systematic review and meta-analysis was registered in PROSPERO with id no. CRD42024608206. A systematic literature review was performed according to the PRISMA checklist, consulting Embase, PubMed, Scopus, and Web of Science databases.

resultsScreened studies considered median values for PFS and Hazard Ratio for OS. Heterogeneity among the selected studies was statistically significant both for PFS (P < 0.001; tau2 = 0.72; I2 = 98.67%) and OS (P = 0.010; tau2 = 0.24; I2 = 87.76%). Data indicated that PFS median values were longer in the experimental group than in the control one (Z = 4.46; P < 0.001). The results for OS showing no statistically significant difference between groups (HR = 0.79; P = 0.45).

conclusionThe present findings confirmed the outcomes improvements provided by nal-IRI for PDAC patients; however, our results should be interpreted cautiously. More data regarding the role of performance status, patient population, the line of treatment, and the role of eventual sequencing various regimens are awaited.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsCarcinoma, Pancreatic DuctalPancreatic NeoplasmsDeoxycytidineFluorouracilGemcitabineHumansIrinotecanLeucovorinLiposomesRandomized Controlled Trials as TopicDeoxycytidineFluorouracilGemcitabineIrinotecanLeucovorinLiposomes5-fluorouracilIrinotecanLeucovorinLiposomalMeta-analysisPancreatic carcinomaSystematic review

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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.