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Systematic Review of Single-Agent vs. Multi-Agent Chemotherapy for Advanced Pancreatic Adenocarcinoma in Elderly vs. Younger Patients

SIMPLE SUMMARY: Pancreatic adenocarcinoma is an aggressive tumour with a high mortality, often diagnosed at advanced stages. The current standard of care for first-line therapy is multi-agent FOLFIRINOX or gemcitabine plus nab-Paclitaxel. Pancreatic adenocarcinoma predominantly effects the elderly p...

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Autores principales: Lewis, Alison, Nagrial, Adnan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10136963/
https://www.ncbi.nlm.nih.gov/pubmed/37190218
http://dx.doi.org/10.3390/cancers15082289
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author Lewis, Alison
Nagrial, Adnan
author_facet Lewis, Alison
Nagrial, Adnan
author_sort Lewis, Alison
collection PubMed
description SIMPLE SUMMARY: Pancreatic adenocarcinoma is an aggressive tumour with a high mortality, often diagnosed at advanced stages. The current standard of care for first-line therapy is multi-agent FOLFIRINOX or gemcitabine plus nab-Paclitaxel. Pancreatic adenocarcinoma predominantly effects the elderly population, albeit these patients are underrepresented in clinical trials. This systematic review aims to review the efficacy of multi-agent versus single-agent chemotherapy for advanced pancreatic adenocarcinoma in elderly versus young populations. ABSTRACT: Purpose: To systematically review all studies comparing multi-agent to single-agent chemotherapy in the first and second-line setting for unresectable pancreatic adenocarcinoma, so as to compare the outcomes of young and elderly patients. Methods: This review searched three databases for relevant studies. The inclusion criteria were diagnosis of locally advanced or metastatic pancreatic adenocarcinoma, comparison of an elderly versus young population, comparison of single-agent versus multi-agent chemotherapy, data on survival outcomes, and randomised controlled trials. The exclusion criteria were phase I trials, incomplete studies, retrospective analyses, systematic reviews, and case reports. A meta-analysis was performed on second-line chemotherapy in elderly patients. Results: Six articles were included in this systematic review. Three of these studies explored first-line treatment and three explored second-line treatment. In the subgroup analysis, the meta-analysis showed statistically improved overall survival for elderly patients receiving single-agent second-line treatment. Conclusions: This systematic review confirmed that combination chemotherapy improved survival in the first-line treatment of advanced pancreatic adenocarcinoma, regardless of age. The benefit of combination chemotherapy in second-line studies for elderly patients with advanced pancreas cancer was less clear.
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spelling pubmed-101369632023-04-28 Systematic Review of Single-Agent vs. Multi-Agent Chemotherapy for Advanced Pancreatic Adenocarcinoma in Elderly vs. Younger Patients Lewis, Alison Nagrial, Adnan Cancers (Basel) Systematic Review SIMPLE SUMMARY: Pancreatic adenocarcinoma is an aggressive tumour with a high mortality, often diagnosed at advanced stages. The current standard of care for first-line therapy is multi-agent FOLFIRINOX or gemcitabine plus nab-Paclitaxel. Pancreatic adenocarcinoma predominantly effects the elderly population, albeit these patients are underrepresented in clinical trials. This systematic review aims to review the efficacy of multi-agent versus single-agent chemotherapy for advanced pancreatic adenocarcinoma in elderly versus young populations. ABSTRACT: Purpose: To systematically review all studies comparing multi-agent to single-agent chemotherapy in the first and second-line setting for unresectable pancreatic adenocarcinoma, so as to compare the outcomes of young and elderly patients. Methods: This review searched three databases for relevant studies. The inclusion criteria were diagnosis of locally advanced or metastatic pancreatic adenocarcinoma, comparison of an elderly versus young population, comparison of single-agent versus multi-agent chemotherapy, data on survival outcomes, and randomised controlled trials. The exclusion criteria were phase I trials, incomplete studies, retrospective analyses, systematic reviews, and case reports. A meta-analysis was performed on second-line chemotherapy in elderly patients. Results: Six articles were included in this systematic review. Three of these studies explored first-line treatment and three explored second-line treatment. In the subgroup analysis, the meta-analysis showed statistically improved overall survival for elderly patients receiving single-agent second-line treatment. Conclusions: This systematic review confirmed that combination chemotherapy improved survival in the first-line treatment of advanced pancreatic adenocarcinoma, regardless of age. The benefit of combination chemotherapy in second-line studies for elderly patients with advanced pancreas cancer was less clear. MDPI 2023-04-13 /pmc/articles/PMC10136963/ /pubmed/37190218 http://dx.doi.org/10.3390/cancers15082289 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Systematic Review
Lewis, Alison
Nagrial, Adnan
Systematic Review of Single-Agent vs. Multi-Agent Chemotherapy for Advanced Pancreatic Adenocarcinoma in Elderly vs. Younger Patients
title Systematic Review of Single-Agent vs. Multi-Agent Chemotherapy for Advanced Pancreatic Adenocarcinoma in Elderly vs. Younger Patients
title_full Systematic Review of Single-Agent vs. Multi-Agent Chemotherapy for Advanced Pancreatic Adenocarcinoma in Elderly vs. Younger Patients
title_fullStr Systematic Review of Single-Agent vs. Multi-Agent Chemotherapy for Advanced Pancreatic Adenocarcinoma in Elderly vs. Younger Patients
title_full_unstemmed Systematic Review of Single-Agent vs. Multi-Agent Chemotherapy for Advanced Pancreatic Adenocarcinoma in Elderly vs. Younger Patients
title_short Systematic Review of Single-Agent vs. Multi-Agent Chemotherapy for Advanced Pancreatic Adenocarcinoma in Elderly vs. Younger Patients
title_sort systematic review of single-agent vs. multi-agent chemotherapy for advanced pancreatic adenocarcinoma in elderly vs. younger patients
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10136963/
https://www.ncbi.nlm.nih.gov/pubmed/37190218
http://dx.doi.org/10.3390/cancers15082289
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