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Research article
Meta-analysis and indirect treatment comparison of modified FOLFIRINOX and gemcitabine plus nab-paclitaxel as first-line chemotherapy in advanced pancreatic cancer
Tao Zhang
Cancer center, Union Hospital, Huazhong University of Science and Technology
Corresponding Author
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Background: Modified FOLFIRINOX and gemcitabine plus nab-paclitaxel (GEM-NAB) have been recommended as first-line therapies for advanced pancreatic cancer (PC) at present. Due to the lack of direct comparison, we conducted this network meta-analysis to indirectly compare the effectiveness and toxicity of modified FOLFIRINOX and GEM-NAB.
Methods: The eligible retrospective studies of treatments related to modified FOLFIRINOX and GEM-NAB were searched up to 4 April 2020. We used the frequentist model to analyze the survival and toxicity data between different treatments. Pooled analysis for overall survival (OS), progression-free survival (PFS), objective response rate (ORR) and events of toxicity were analyzed in this study.
Results: Twenty-two studies including 6351 patients were involved in this network meta-analysis. The comparisons based on OS and PFS showed that modified FOLFIRINOX and GEM-NAB had similar treatment efficacy. But GEM-NAB was more effective than modified FOLFIRINOX based on the result of ORR (RR: 0.70; 95% CI: 0.51-0.96). Moreover, our analysis showed a similar toxicity profile between modified FOLFIRINOX and GEM-NAB.
Conclusions: Based on current evidence, modified FOLFIRINOX and GEM-NAB were similar in survival and toxicity comparisons. Many factors should be considered for the optimal treatment formulation and our meta-analysis could provide some guidance to treatment selection in the first-line setting for advanced PC.
Keywords
pancreatic cancer, modified FOLFIRINOX, gemcitabine, nab-paclitaxel, network meta-analysis, systematic review
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CURRENT STATUS: Under Review
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Posted 22 Jun, 2020
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Received 26 Aug, 2020
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This preprint is under consideration at BMC Cancer. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Meta-analysis and indirect treatment comparison of modified FOLFIRINOX and gemcitabine plus nab-paclitaxel as first-line chemotherapy in advanced pancreatic cancer
Tao Zhang
Cancer center, Union Hospital, Huazhong University of Science and Technology
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 22 Jun, 2020
No community comments so far
Review #1 received
Received 26 Aug, 2020
Reviewer #1 agreed
On 06 Aug, 2020
Reviewers invited
Invitations sent on 02 Jul, 2020
Editor assigned
On 14 Jun, 2020
Submission checks complete
On 13 Jun, 2020
Editor invited
On 13 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Modified FOLFIRINOX and gemcitabine plus nab-paclitaxel (GEM-NAB) have been recommended as first-line therapies for advanced pancreatic cancer (PC) at present. Due to the lack of direct comparison, we conducted this network meta-analysis to indirectly compare the effectiveness and toxicity of modified FOLFIRINOX and GEM-NAB.
Methods: The eligible retrospective studies of treatments related to modified FOLFIRINOX and GEM-NAB were searched up to 4 April 2020. We used the frequentist model to analyze the survival and toxicity data between different treatments. Pooled analysis for overall survival (OS), progression-free survival (PFS), objective response rate (ORR) and events of toxicity were analyzed in this study.
Results: Twenty-two studies including 6351 patients were involved in this network meta-analysis. The comparisons based on OS and PFS showed that modified FOLFIRINOX and GEM-NAB had similar treatment efficacy. But GEM-NAB was more effective than modified FOLFIRINOX based on the result of ORR (RR: 0.70; 95% CI: 0.51-0.96). Moreover, our analysis showed a similar toxicity profile between modified FOLFIRINOX and GEM-NAB.
Conclusions: Based on current evidence, modified FOLFIRINOX and GEM-NAB were similar in survival and toxicity comparisons. Many factors should be considered for the optimal treatment formulation and our meta-analysis could provide some guidance to treatment selection in the first-line setting for advanced PC.
Figure 1
Figure 2