Figures (3)  Tables (5)

    • Figure 1. 

      Progression-free survival with modified FOLFIRINOX (mFFX) and Nab-paclitaxel + Gemcitabine (Nab-G).

    • Figure 2. 

      Overall survival with modified FOLFIRINOX (mFFX) and Nab-paclitaxel + Gemcitabine (Nab-G).

    • Figure 3. 

      Overall survival according to second-line treatment.

    • Variables Total
      (n = 71)      		 mFFX
      (n = 54)      		 Nab-G
      (n = 17)      		 p-value
      Age, median (min-max) 63.0 (37−82) 63.0 (37−82) 63.0 (42−77) 0.762
      Gender, n (%)
      Female 25 (35.2) 17 (31.5) 8 (47.1) 0.241
      Male 46 (64.8) 37 (68.5) 9 (52.9)
      ECOG PS, n (%)
      0 14 (19.7) 13 (24.1) 1 (5.9) 0.197
      1 40 (56.3) 30 (55.6) 10 (58.8)
      2 17 (23.9) 11 (20.4) 6 (35.3)
      T stage, n (%)
      T2 19 (26.8) 17 (31.5) 2 (11.8) 0.207
      T3 35 (49.3) 26 (48.1) 9 (52.9)
      T4 17 (23.9) 11 (20.4) 6 (35.3)
      Median tumor diameter, cm (IQR) 4.5 (2.7) 4.5 (2.9) 4.5 (1.8) 0.267
      Tumor diameter, cm, n (%)*
      ≤ 4.50 38 (53.5) 29 (53.7) 9 (52.9) 0.839
      > 4.50 31 (43.6) 23 (42.6) 8 (47.1)
      Primary tumor location, n (%)
      Head 35 (49.3) 24 (44.4) 11 (64.7) 0.443
      Corpus 18 (25.4) 15 (27.8) 3 (17.6)
      Tail 18 (25.4) 15 (27.8) 3 (17.6)
      CA 19.9 (U/ml), median (IQR) 1,361 (4,882.6) 1,506.6 (4,956.8) 698.8 (6,364.1) 0.370
      Liver metastasis, n (%)
      No 21 (29.6) 18 (33.3) 3 (17.6) 0.055
      Yes 50 (70.4) 36 (66.7) 14 (82.4)
      Lung metastasis, n (%)
      No 57 (80.3) 42 (77.8) 15 (88.2) 0.493
      Yes 14 (19.7) 12 (22.2) 2 (11.8)
      Bone metastasis, n (%)
      No 65 (91.5) 50 (92.6) 15 (88.2) 0.625
      Yes 6 (8.5) 4 (7.4) 2 (11.8)
      Lymph node metastasis, n (%)
      No 23 (32.4) 16 (29.6) 7 (41.2) 0.375
      Yes 48 (67.6) 38 (70.4) 10 (58.8)
      Other metastasis sites, n (%)
      No 60 (84.5) 43 (79.6) 17 (100) 0.055
      Yes** 11 (15.5) 11 (20.4) 0 (0)
      mFFX, modified FOLFIRINOX; Nab G, Nab-paclitaxel + Gemcitabine; ECOG PS, Eastern Cooperative Oncology Group Performance Status. * The maximum tumor diameter of two patients on imaging was not specified, ** Periton or surrenal gland metastasis.

      Table 1. 

      Baseline demographic and clinicopathologic characteristics of the patients.

    • Best response, n (%) First-line treatment p-value
      mFFX Nab-G
      Objective response rate (CR + PR) 22 (40.7) 4 (23.5) 0.199
      Disease control rate (CR + PR + SD) 35 (64.8) 5 (29.4) 0.010
      SD 13 (24.1) 1 (5.9) 0.068
      PR 17 (31.5) 4 (23.5)
      CR 5 (9.3) 0 (0)
      PD 19 (35.2) 12 (70.6)
      mFFX, modified FOLFIRINOX; Nab-G, nab-paclitaxel + Gemcitabine; SD, stable disease; PR, partial response; CR, complete response; PD, progressive disease; the number in bold indicates statistical significance.

      Table 2. 

      Efficacy of first-line treatments.

    • Variables Univariate analysis (PFS) Univariate analysis (OS)
      HR (95% CI) p-value HR (95% CI) p-value
      Gender (ref: male) 1.20 (0.73−1.98) 0.472 1.41 (0.82−2.41) 0.210
      Age 1.01 (0.98−1.03) 0.731 1.02 (0.99−1.04) 0.129
      ECOG PS (ref: 0) 0.244 0.101
      1 0.94 (0.50−1.76) 0.852 0.85 (0.44−1.61) 0.621
      2 1.55 (0.75−3.18) 0.230 1.70 (0.81−3.56) 0.157
      T stage (ref: T2) 0.934 0.622
      T3 0.95 (0.54−1.72) 0.887 0.79 (0.42−1.47) 0.465
      T4 1.07 (0.51−2.11) 0.845 1.06 (0.51−2.22) 0.879
      Tumor diameter, cm (ref: ≤ 4.50) 0.77 (0.47−1.26) 0.308 1.02 (0.60−1.72) 0.930
      Primary tumor location (ref: head) 0.352 0.339
      Corpus 0.68 (0.37−1.23) 0.207 0.87 (0.46−1.65) 0.678
      Tail 0.72 (0.40−1.30) 0.278 0.62 (0.33−1.17) 0.142
      CA 19.9 level (ref: < 1361 U/ml) 0.85 (0.51−1.42) 0.547 0.77 (0.44−1.34) 0.364
      Liver metastasis (ref: no) 0.94 (0.56−1.58) 0.836 0.80 (0.46−1.39) 0.433
      Lung metastasis (ref: no) 1.20 (0.66−2.19) 0.540 1.51 (0.80−2.85) 0.198
      Bone metastasis (ref: no) 1.05 (0.45−2.46) 0.904 1.47 (0.62−3.44) 0.376
      Lymph node metastasis (ref: no) 1.26 (0.75−2.13) 0.370 1.13 (0.65−1.98) 0.657
      PFS, progression−free survival; OS, overall survival; HR, hazard ratio; CI, confidence interval; ref, reference; ECOG PS, Eastern Cooperative Oncology Group Performance Status. As no statistically significant variables were identified in the univariate analysis, multivariate analysis was not performed.

      Table 3. 

      Univariate Cox regression analysis for progression-free survival and overall survival.

    • First-line treatment Second-line treatment n (%)
      mFFX None 24 (47)
      Nab-G 18 (35.3)
      Gemcitabine 6 (11.8)
      Cisplatin + Gemcitabine 3 (5.9)
      Nab-G None 15 (88.2)
      mFFX 1 (5.9)
      mFOLFOX6 1 (5.9)
      mFFX, modified FOLFIRINOX; Nab-G, nab-paclitaxel + Gemcitabine.

      Table 4. 

      Second-line treatments.

    • Adverse event, n (%) mFFX (n = 54) Nab-G (n = 17) p-value
      Grade 1−2 Grade 3−4 Grade 1−2 Grade 3−4
      Hematologic
      Neutropenia 9 (17) 18 (33) 2 (12) 5 (29) 0.596
      Anemia 14 (26) 6 (11) 7 (41) 3 (18) 0.669
      Thrombocytopenia 16 (29) 7 (13) 3 (18) 5 (29) 0.206
      Non-hematologic
      Fatigue 27 (50) 1 (2) 12 (70) 2 (12) 0.254
      Nausea 15 (28) 7 (13) 8 (47) 1 (6) 0.379
      Vomiting 17 (31) 3 (5) 6 (35) 1 (6) 1.000
      Diarrhea 5 (9) 0 0 0 N/A
      Stomatitis/mucositis 8 (15) 1 (2) 3 (18) 1 (6) 1.000
      mFFX Nab-G p-value
      Febrile neutropenia 2 (4) 0 0.631
      Dose reduction 31 (57) 3 (18) 0.004
      Dose delay 32 (59) 12 (70) 0.401
      Hospitalization 14 (26) 6 (35) 0.540
      mFFX, modified FOLFIRINOX; Nab-G, nab-paclitaxel + Gemcitabine; N/A, not applicable. Fisher's Exact test; numbers in bold indicate statistical significance.

      Table 5. 

      Safety profile of first-line treatment options.