Real-World Clinical Practice of Intensified Chemotherapies for Metastatic Pancreatic Cancer: Results from a Pan-European Questionnaire Study

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Introduction: Recently, FOLFIRINOX and gemcitabine + nab-paclitaxel have been introduced as a novel intensified chemotherapy regimen for patients with metastasized pancreatic cancer. This study aims to analyze the real-world clinical practice with FOLFIRINOX and gemcitabine + nab-paclitaxel across Europe. Methods: Invitations to participate in an anonymous web-based questionnaire were sent via e-mail to 5,420 doctors in 19 European countries through the network of national gastroenterological, oncological, surgical and pancreatic societies as well as the European Pancreatic Club. The questionnaire consisted of 20 questions, 14 regarding the use of intensified chemotherapy, 4 regarding demographics of the participants, and 1 to verify the active involvement in the management of metastatic pancreatic cancer. Results: Two hundred and thirteen responses were received and 153 entries were valid for analysis. Of those, 63.4% came from an academic institution, 51% were oncologists, and 52% treated more than 25 cases per year. A majority of responses (71%) were from Italy (40%), Germany (23%), and Spain (8%). As first-line therapy, 11% used gemcitabine +/- erlotinib, 42% used FOLFIRINOX, and 47% used gemcitabine + nab-paclitaxel. Of the intensified regimens, both were applied to equal parts, but the likelihood of protocol deviation was higher when using FOLFIRINOX ( p < 0.01). FOLFIRINOX was considered more toxic than gemcitabine + nab-paclitaxel (neutropenia 88 vs. 68%; polyneuropathy 42 vs. 41%; rapid deterioration 42 vs. 31%). FOLFIRINOX was rated to achieve longer survival with an acceptable quality of life (52 vs. 44%). Moreover, 57% of participants thought that gemcitabine + nab-paclitaxel should be the backbone for further clinical trials in pancreatic cancer. Conclusion: Intensified chemotherapy is widely used in pancreatic cancer patients in Europe following its recent clinical approval. Interestingly, nab-paclitaxel and FOLFIRINOX were used at comparable frequency although the latter had to be de-escalated more often.

Related collections

Author and article information

Journal

Journal ID (publisher-id): DIG

Journal ID (nlm-ta): Digestion

Journal ID (doi): 10.1159/issn.0012-2823

Title: Digestion

Publisher: S. Karger AG

ISSN (Print): 0012-2823

ISSN (Electronic): 1421-9867

Publication date Subscription-year: 2016

Publication date (Print): January 2017

Publication date (Electronic): 29 December 2016

Volume: 94

Issue: 4

Pages: 222-229

Affiliations

^aSecond Internal Medicine Department, Gastroenterology Division, Semmelweis University, Budapest, Hungary; ^bDepartment of Surgery, University of Pavia, Matteo University Hospital Foundation, Pavia, Italy; ^cNIHR Liverpool Pancreas Biomedical Research Unit, Department of Molecular and Clinical Cancer Medicine, Royal Liverpool University Hospital, Liverpool, UK; ^dDepartment of Surgical and Perioperative Sciences, University of Umea, Umea, Sweden; ^eDepartment of Gastroenterology and Hepatology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), ^fSection Methods in Community Medicine, Institute for Community Medicine, Ernst-Moritz-Arnd-University Greifswald, and ^gDepartment of Medicine A, University Medicine Greifswald, Greifswald, and ^hDepartment of Gastroenterology and Gastrointestinal Oncology, University Medical Centre Goettingen, Goettingen, Germany

Author notes

*Albrecht Neesse, MD, PhD, Department Gastroenterology and Gastrointestinal Oncology, University Medical Centre Goettingen, Robert-Koch Str. 40, DE-35085 Goettingen (Germany), E-Mail albrecht.neesse@med.uni-goettingen.de

Author information

Georg Beyer https://orcid.org/0000-0002-7607-8264

Article

Publisher ID: 453257 Other ID: Digestion 2016;94:222-229

DOI: 10.1159/000453257

PubMed ID: 28030863

SO-VID: 60551430-0d95-4f6e-98a7-76105d0713c5

License:

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

History

Date received : 20 June 2016

Date accepted : 05 November 2016

Page count

Figures: 3, Tables: 2, References: 21, Pages: 8

Comments

Comment on this article

scite_

Cited by 11

See all cited by

- Version 1

Call for Papers: Artificial Intelligence in Gastroenterology

Submit here before May 31, 2024