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This analysis examines the efficacy and tolerability of NALIRIFOX versus standard chemotherapy in older patients with metastatic pancreatic cancer.

February 16, 2026Open Access

NALIRIFOX versus nab-paclitaxel and gemcitabine in older patients with treatment-naive metastatic pancreatic cancer: a subgroup analysis of the pivotal NAPOLI 3 trial

Key Points

This analysis examines the efficacy and tolerability of NALIRIFOX versus standard chemotherapy in older patients with metastatic pancreatic cancer.
Analyzed data from the pivotal NAPOLI 3 trial
Focused on treatment-naive older patients
Compared survival rates between NALIRIFOX and standard regimens (gemcitabine + nab-paclitaxel)
NALIRIFOX improved survival rates in older patients compared to gemcitabine + nab-paclitaxel
No reduction in treatment tolerability was observed in older patients
Supports NALIRIFOX as a viable first-line treatment option for older adults with metastatic pancreatic cancer

Abstract

NALIRIFOX improved mPDAC survival versus Gem + NabP irrespective of patient age, with no signals for reduced tolerability in the older (versus younger) patients. The results provide reassurance that triplet therapy with NALIRIFOX is an efficacious and tolerable regimen in older treatment-naive patients with mPDAC who were fit enough for inclusion in NAPOLI 3, supporting consideration of its use as 1L therapy in this population.

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