Sonboi MB et al.

Summary -Fluoropyrimidine (FP) with irinotecan was shown to be the appropriate next line of treatment upon progression after gemcitabine-based chemotherapy regimens in patients with pancreatic ductal adenocarcinoma (PDAC).

Methods
A literature search and meta-analysis was conducted of randomized controlled trials comparing FP monotherapy versus FP combination therapy, including oxaliplatin (FPOX) or irinotecan (FPIRI) in patients with PDAC who progressed after first-line treatment.

Results
5 studied with 895 patients were evaluated.
FPIRI/FPOX had a significantly improved PFS and a trend toward improved OS compared with FP monotherapy.
Based on a comparison of FPIRI with FP, there was an improvement in PFS (HR, 0.64) and OS (HR, 0.70) in patients who received the combination.
FPOX yielded a modest improvement in PFS with no improvement in OS.