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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...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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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 |
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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 |
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