Supplementary Material for: Real-World Clinical Practice of Intensified Chemotherapies for Metastatic Pancreatic Cancer: Results from a Pan-European Questionnaire Study
Le N.
Vinci A.
Schober M.
Krug S.
Javed M.A.
Kohlmann T.
Sund M.
Neesse A.
Beyer G.
10.6084/m9.figshare.4499093.v1
https://karger.figshare.com/articles/journal_contribution/Supplementary_Material_for_Real-World_Clinical_Practice_of_Intensified_Chemotherapies_for_Metastatic_Pancreatic_Cancer_Results_from_a_Pan-European_Questionnaire_Study/4499093
<p><b><i>Introduction:</i></b> Recently, FOLFIRINOX and gemcitabine +
nab-paclitaxel have been introduced as a novel intensified chemotherapy
regimen for patients with metastasized pancreatic cancer. This study
aims to analyze the real-world clinical practice with FOLFIRINOX and
gemcitabine + nab-paclitaxel across Europe. <b><i>Methods:</i></b>
Invitations to participate in an anonymous web-based questionnaire were
sent via e-mail to 5,420 doctors in 19 European countries through the
network of national gastroenterological, oncological, surgical and
pancreatic societies as well as the European Pancreatic Club. The
questionnaire consisted of 20 questions, 14 regarding the use of
intensified chemotherapy, 4 regarding demographics of the participants,
and 1 to verify the active involvement in the management of metastatic
pancreatic cancer. <b><i>Results:</i></b> Two hundred and thirteen
responses were received and 153 entries were valid for analysis. Of
those, 63.4% came from an academic institution, 51% were oncologists,
and 52% treated more than 25 cases per year. A majority of responses
(71%) were from Italy (40%), Germany (23%), and Spain (8%). As
first-line therapy, 11% used gemcitabine +/- erlotinib, 42% used
FOLFIRINOX, and 47% used gemcitabine + nab-paclitaxel. Of the
intensified regimens, both were applied to equal parts, but the
likelihood of protocol deviation was higher when using FOLFIRINOX (<i>p</i>
< 0.01). FOLFIRINOX was considered more toxic than gemcitabine +
nab-paclitaxel (neutropenia 88 vs. 68%; polyneuropathy 42 vs. 41%; rapid
deterioration 42 vs. 31%). FOLFIRINOX was rated to achieve longer
survival with an acceptable quality of life (52 vs. 44%). Moreover, 57%
of participants thought that gemcitabine + nab-paclitaxel should be the
backbone for further clinical trials in pancreatic cancer. <b><i>Conclusion:</i></b>
Intensified chemotherapy is widely used in pancreatic cancer patients
in Europe following its recent clinical approval. Interestingly,
nab-paclitaxel and FOLFIRINOX were used at comparable frequency although
the latter had to be de-escalated more often.</p>
2016-12-28 12:49:32
Pancreatic cancer
Palliative chemotherapy
FOLFIRINOX
Nab-paclitaxel