Comparison of two standard first-line treatments in metastatic pancreatic cancer

FOLFIRINOX or modified FOLFIRINOX (mFFX) and nab-paclitaxel plus gemcitabine (Nab-G) are both standard first-line treatment options in metastatic pancreatic cancer (mPC). This study aimed to analyze the efficacy and safety of mFFX and Nab-G as first-line treatments in real-life situations. mPC patients treated with either mFFX or Nab-G as first-line were retrospectively analyzed. The Kaplan-Meier method was used to estimate progression-free survival (PFS) and overall survival (OS), and the log-rank test was used to compare groups. There were 54 and 17 patients in the mFFX and Nab-G groups respectively. Baseline characteristics were comparable. The disease control rate (DCR) was 64.8% in the mFFX group and 29.4% in the Nab-G group (p = 0.01). The median PFS (mFFX: 6.3 months vs Nab-G: 3.6 months; p = 0.021) and the median OS (mFFX: 11.5 months vs Nab-G: 7.6 months; p = 0.013) were statistically higher in the mFFX group. The median OS was prolonged in patients who received second-line treatment (14 vs 8.6 months; p = 0.007). There was no significant difference between the two groups in terms of grade 3−4 toxicity. Our study demonstrated better DCR and increased survival outcomes with mFFX vs Nab-G with comparable toxicity profiles.