Second-Line Systemic Therapy Following First-Line FOLFIRINOX or NALIRIFOX in Metastatic Pancreatic Ductal Adenocarcinoma: A Systematic Review and Meta-Analysis.
J Gastrointest CancerSep 28, 2026 (epub)
Pouyan Shaker, Daniyaal Kamran, Lingling Du et al.
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In 30 seconds
This systematic review and meta-analysis evaluated second-line therapies following first-line FOLFIRINOX or NALIRIFOX in 3888 adults with metastatic pancreatic ductal adenocarcinoma. The analysis revealed a pooled median overall survival of 7.57 months and a median progression-free survival of 3.18 months, indicating meaningful benefits for selected patients receiving second-line treatment.
Key findings
- Pooled median overall survival from second-line initiation was 7.57 months.
- Pooled median progression-free survival was 3.18 months.
- Pooled objective response rate was 11.6%.
- Combination gemcitabine-based regimens outperformed monotherapy, especially in ECOG 0-1 patients.
Why it matters
Understanding the effectiveness of second-line therapies after FOLFIRINOX or NALIRIFOX is crucial for optimizing treatment strategies in metastatic pancreatic ductal adenocarcinoma, particularly as these regimens become more common.