Pancreas Cancer

Question 1

NAPOLI-3

In patients with metastatic pancreatic cancer, the NAPOLI-3 trial compared which regimens? What was the primary endpoint?

Answer 1

First line treatment comparing liposomal irinotecan, oxaliplatin, leucovorin, and 5-FU (NALIRIFOX) versus nab-paclitaxel and gemcetabine. Primary end point was overall survival

OS benefit was seen with NALIRIFOX (mOS 11.1 months) versus Nab-paclitax

Wainberg, Lancet, 2023

Question 2

liposomal irinotecan

What is the advantage of liposomal irinotecan compared to irinotecan?

Answer 2

Liposomal irinotecan is encapsulated irinotecan which allows it to stay in the circulation longer, thus demonstrating higher and sustained levels of irinotecan in the tumor

Question 3

NAPOLI-1

For patients with metastatic pancreas cancer who were failed by first line gemcitabine-based therapy what treatments were studied in the NAPOLI-1 trial? What was the primary endpoint?

Answer 3

Second line trial in those progressing on first line gemcitabine based treatment randomized to either liposomal irinotecan monotherapy, liposomal irinotecan/5-FU/LV, or FU plus leucovorin only. Primary endpoint was OS.

RESULTS: Liposomal Irinotecan/5-FU/LV mOS 6.1 months, versus 5-FU/LV

liposomal irinotecan monotherapy did not differ from 5-FU/LV.

Wang-Gillam, Lancet, 2016