Cargando…

A Retrospective Study Investigating the Safety and Efficacy of Nanoliposomal Irinotecan in Elderly Patients with Unresectable Pancreatic Cancer

Although nanoliposomal irinotecan combined with 5-fluorouracil and leucovorin (nal-IRI+5-FU/LV) has been used to treat first-line resistant unresectable pancreatic cancer, the efficacy and safety data among the elderly remain limited. We retrospectively analyzed clinical outcomes among elderly patie...

Descripción completa

Detalles Bibliográficos
Autores principales: Ikoma, Tatsuki, Matsumoto, Toshihiko, Boku, Shogen, Yasuda, Tomoyo, Masuda, Masataka, Ito, Takashi, Nakamaru, Koh, Yamaki, So, Nakayama, Shinji, Hashimoto, Daisuke, Yamamoto, Tomohisa, Shibata, Nobuhiro, Ikeura, Tsukasa, Naganuma, Makoto, Satoi, Sohei, Kurata, Takayasu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10218867/
https://www.ncbi.nlm.nih.gov/pubmed/37240585
http://dx.doi.org/10.3390/jcm12103477
_version_ 1785048875670700032
author Ikoma, Tatsuki
Matsumoto, Toshihiko
Boku, Shogen
Yasuda, Tomoyo
Masuda, Masataka
Ito, Takashi
Nakamaru, Koh
Yamaki, So
Nakayama, Shinji
Hashimoto, Daisuke
Yamamoto, Tomohisa
Shibata, Nobuhiro
Ikeura, Tsukasa
Naganuma, Makoto
Satoi, Sohei
Kurata, Takayasu
author_facet Ikoma, Tatsuki
Matsumoto, Toshihiko
Boku, Shogen
Yasuda, Tomoyo
Masuda, Masataka
Ito, Takashi
Nakamaru, Koh
Yamaki, So
Nakayama, Shinji
Hashimoto, Daisuke
Yamamoto, Tomohisa
Shibata, Nobuhiro
Ikeura, Tsukasa
Naganuma, Makoto
Satoi, Sohei
Kurata, Takayasu
author_sort Ikoma, Tatsuki
collection PubMed
description Although nanoliposomal irinotecan combined with 5-fluorouracil and leucovorin (nal-IRI+5-FU/LV) has been used to treat first-line resistant unresectable pancreatic cancer, the efficacy and safety data among the elderly remain limited. We retrospectively analyzed clinical outcomes among elderly patients. Patients treated with nal-IRI+5-FU/LV were assigned to the elderly (≥75 years) and non-elderly (<75 years) groups. Herein, 85 patients received nal-IRI+5-FU/LV, with 32 assigned to the elderly group. Patient characteristics in the elderly and non-elderly groups were as follows: age: 78.5 (75–88)/71 (48–74), male: 17/32 (53%/60%), performance status (ECOG) 0:9/20 (28%/38%), nal-IRI+5-FU/LV in second line: 23/24 (72%/45%), respectively. A significantly high number of elderly patients exhibited aggravated kidney and hepatic functions. Median overall survival (OS) and progression-free survival (PFS) in the elderly group vs. non-elderly group were 9.4 months vs. 9.9 months (hazard ratio (HR) 1.51, 95% confidence interval (CI) 0.85–2.67, p = 0.16) and 3.4 months vs. 3.7 months (HR 1.41, 95% CI 0.86–2.32, p = 0.17). Both groups exhibited a similar incidence of efficacy and adverse events. There were no significant differences in OS and PFS between groups. We analyzed the C-reactive protein/albumin ratio (CAR) and neutrophil/lymphocyte ratio (NLR) as indicators that could determine eligibility for nal-IRI+5-FU/LV. The median CAR and NLR scores in the ineligible group were 1.17 and 4.23 (p < 0.001 and p = 0.018, respectively). Elderly patients with worse CAR and NLR score could be deemed ineligible for nal-IRI+5-FU/LV.
format Online
Article
Text
id pubmed-10218867
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-102188672023-05-27 A Retrospective Study Investigating the Safety and Efficacy of Nanoliposomal Irinotecan in Elderly Patients with Unresectable Pancreatic Cancer Ikoma, Tatsuki Matsumoto, Toshihiko Boku, Shogen Yasuda, Tomoyo Masuda, Masataka Ito, Takashi Nakamaru, Koh Yamaki, So Nakayama, Shinji Hashimoto, Daisuke Yamamoto, Tomohisa Shibata, Nobuhiro Ikeura, Tsukasa Naganuma, Makoto Satoi, Sohei Kurata, Takayasu J Clin Med Article Although nanoliposomal irinotecan combined with 5-fluorouracil and leucovorin (nal-IRI+5-FU/LV) has been used to treat first-line resistant unresectable pancreatic cancer, the efficacy and safety data among the elderly remain limited. We retrospectively analyzed clinical outcomes among elderly patients. Patients treated with nal-IRI+5-FU/LV were assigned to the elderly (≥75 years) and non-elderly (<75 years) groups. Herein, 85 patients received nal-IRI+5-FU/LV, with 32 assigned to the elderly group. Patient characteristics in the elderly and non-elderly groups were as follows: age: 78.5 (75–88)/71 (48–74), male: 17/32 (53%/60%), performance status (ECOG) 0:9/20 (28%/38%), nal-IRI+5-FU/LV in second line: 23/24 (72%/45%), respectively. A significantly high number of elderly patients exhibited aggravated kidney and hepatic functions. Median overall survival (OS) and progression-free survival (PFS) in the elderly group vs. non-elderly group were 9.4 months vs. 9.9 months (hazard ratio (HR) 1.51, 95% confidence interval (CI) 0.85–2.67, p = 0.16) and 3.4 months vs. 3.7 months (HR 1.41, 95% CI 0.86–2.32, p = 0.17). Both groups exhibited a similar incidence of efficacy and adverse events. There were no significant differences in OS and PFS between groups. We analyzed the C-reactive protein/albumin ratio (CAR) and neutrophil/lymphocyte ratio (NLR) as indicators that could determine eligibility for nal-IRI+5-FU/LV. The median CAR and NLR scores in the ineligible group were 1.17 and 4.23 (p < 0.001 and p = 0.018, respectively). Elderly patients with worse CAR and NLR score could be deemed ineligible for nal-IRI+5-FU/LV. MDPI 2023-05-15 /pmc/articles/PMC10218867/ /pubmed/37240585 http://dx.doi.org/10.3390/jcm12103477 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 Article
Ikoma, Tatsuki
Matsumoto, Toshihiko
Boku, Shogen
Yasuda, Tomoyo
Masuda, Masataka
Ito, Takashi
Nakamaru, Koh
Yamaki, So
Nakayama, Shinji
Hashimoto, Daisuke
Yamamoto, Tomohisa
Shibata, Nobuhiro
Ikeura, Tsukasa
Naganuma, Makoto
Satoi, Sohei
Kurata, Takayasu
A Retrospective Study Investigating the Safety and Efficacy of Nanoliposomal Irinotecan in Elderly Patients with Unresectable Pancreatic Cancer
title A Retrospective Study Investigating the Safety and Efficacy of Nanoliposomal Irinotecan in Elderly Patients with Unresectable Pancreatic Cancer
title_full A Retrospective Study Investigating the Safety and Efficacy of Nanoliposomal Irinotecan in Elderly Patients with Unresectable Pancreatic Cancer
title_fullStr A Retrospective Study Investigating the Safety and Efficacy of Nanoliposomal Irinotecan in Elderly Patients with Unresectable Pancreatic Cancer
title_full_unstemmed A Retrospective Study Investigating the Safety and Efficacy of Nanoliposomal Irinotecan in Elderly Patients with Unresectable Pancreatic Cancer
title_short A Retrospective Study Investigating the Safety and Efficacy of Nanoliposomal Irinotecan in Elderly Patients with Unresectable Pancreatic Cancer
title_sort retrospective study investigating the safety and efficacy of nanoliposomal irinotecan in elderly patients with unresectable pancreatic cancer
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10218867/
https://www.ncbi.nlm.nih.gov/pubmed/37240585
http://dx.doi.org/10.3390/jcm12103477
work_keys_str_mv AT ikomatatsuki aretrospectivestudyinvestigatingthesafetyandefficacyofnanoliposomalirinotecaninelderlypatientswithunresectablepancreaticcancer
AT matsumototoshihiko aretrospectivestudyinvestigatingthesafetyandefficacyofnanoliposomalirinotecaninelderlypatientswithunresectablepancreaticcancer
AT bokushogen aretrospectivestudyinvestigatingthesafetyandefficacyofnanoliposomalirinotecaninelderlypatientswithunresectablepancreaticcancer
AT yasudatomoyo aretrospectivestudyinvestigatingthesafetyandefficacyofnanoliposomalirinotecaninelderlypatientswithunresectablepancreaticcancer
AT masudamasataka aretrospectivestudyinvestigatingthesafetyandefficacyofnanoliposomalirinotecaninelderlypatientswithunresectablepancreaticcancer
AT itotakashi aretrospectivestudyinvestigatingthesafetyandefficacyofnanoliposomalirinotecaninelderlypatientswithunresectablepancreaticcancer
AT nakamarukoh aretrospectivestudyinvestigatingthesafetyandefficacyofnanoliposomalirinotecaninelderlypatientswithunresectablepancreaticcancer
AT yamakiso aretrospectivestudyinvestigatingthesafetyandefficacyofnanoliposomalirinotecaninelderlypatientswithunresectablepancreaticcancer
AT nakayamashinji aretrospectivestudyinvestigatingthesafetyandefficacyofnanoliposomalirinotecaninelderlypatientswithunresectablepancreaticcancer
AT hashimotodaisuke aretrospectivestudyinvestigatingthesafetyandefficacyofnanoliposomalirinotecaninelderlypatientswithunresectablepancreaticcancer
AT yamamototomohisa aretrospectivestudyinvestigatingthesafetyandefficacyofnanoliposomalirinotecaninelderlypatientswithunresectablepancreaticcancer
AT shibatanobuhiro aretrospectivestudyinvestigatingthesafetyandefficacyofnanoliposomalirinotecaninelderlypatientswithunresectablepancreaticcancer
AT ikeuratsukasa aretrospectivestudyinvestigatingthesafetyandefficacyofnanoliposomalirinotecaninelderlypatientswithunresectablepancreaticcancer
AT naganumamakoto aretrospectivestudyinvestigatingthesafetyandefficacyofnanoliposomalirinotecaninelderlypatientswithunresectablepancreaticcancer
AT satoisohei aretrospectivestudyinvestigatingthesafetyandefficacyofnanoliposomalirinotecaninelderlypatientswithunresectablepancreaticcancer
AT kuratatakayasu aretrospectivestudyinvestigatingthesafetyandefficacyofnanoliposomalirinotecaninelderlypatientswithunresectablepancreaticcancer
AT ikomatatsuki retrospectivestudyinvestigatingthesafetyandefficacyofnanoliposomalirinotecaninelderlypatientswithunresectablepancreaticcancer
AT matsumototoshihiko retrospectivestudyinvestigatingthesafetyandefficacyofnanoliposomalirinotecaninelderlypatientswithunresectablepancreaticcancer
AT bokushogen retrospectivestudyinvestigatingthesafetyandefficacyofnanoliposomalirinotecaninelderlypatientswithunresectablepancreaticcancer
AT yasudatomoyo retrospectivestudyinvestigatingthesafetyandefficacyofnanoliposomalirinotecaninelderlypatientswithunresectablepancreaticcancer
AT masudamasataka retrospectivestudyinvestigatingthesafetyandefficacyofnanoliposomalirinotecaninelderlypatientswithunresectablepancreaticcancer
AT itotakashi retrospectivestudyinvestigatingthesafetyandefficacyofnanoliposomalirinotecaninelderlypatientswithunresectablepancreaticcancer
AT nakamarukoh retrospectivestudyinvestigatingthesafetyandefficacyofnanoliposomalirinotecaninelderlypatientswithunresectablepancreaticcancer
AT yamakiso retrospectivestudyinvestigatingthesafetyandefficacyofnanoliposomalirinotecaninelderlypatientswithunresectablepancreaticcancer
AT nakayamashinji retrospectivestudyinvestigatingthesafetyandefficacyofnanoliposomalirinotecaninelderlypatientswithunresectablepancreaticcancer
AT hashimotodaisuke retrospectivestudyinvestigatingthesafetyandefficacyofnanoliposomalirinotecaninelderlypatientswithunresectablepancreaticcancer
AT yamamototomohisa retrospectivestudyinvestigatingthesafetyandefficacyofnanoliposomalirinotecaninelderlypatientswithunresectablepancreaticcancer
AT shibatanobuhiro retrospectivestudyinvestigatingthesafetyandefficacyofnanoliposomalirinotecaninelderlypatientswithunresectablepancreaticcancer
AT ikeuratsukasa retrospectivestudyinvestigatingthesafetyandefficacyofnanoliposomalirinotecaninelderlypatientswithunresectablepancreaticcancer
AT naganumamakoto retrospectivestudyinvestigatingthesafetyandefficacyofnanoliposomalirinotecaninelderlypatientswithunresectablepancreaticcancer
AT satoisohei retrospectivestudyinvestigatingthesafetyandefficacyofnanoliposomalirinotecaninelderlypatientswithunresectablepancreaticcancer
AT kuratatakayasu retrospectivestudyinvestigatingthesafetyandefficacyofnanoliposomalirinotecaninelderlypatientswithunresectablepancreaticcancer