32. Deutscher Krebskongress Krebsmedizin heute: präventiv, personalisiert, präzise und partizipativ, Berlin, 24.-27. Februar 2016: Abstracts

[[abstract]]Question: Nal-IRI is a nanoliposomal encapsulated formulation of irinotecan. OS in the ITT population was significantly longer with nal-IRI+5FU/LV (n = 117) vs 5FU/LV (n = 119) (median OS was 6.1 m vs 4.2 m; unstratified HR = 0.67, log-rank test p = 0.012). Most frequent grade 3+ AEs included neutropenia, fatigue and GI-effects. Thes e expanded, pre-specified analyses have been presented. Methods: Patients with mPAC (n = 417) previously treated with gemcitabine-based therapy, were randomized 1:1:1 to receive: Nal-IRI (120 mg/m 2 ; IV 90 min) q3w; 5FU (2,000 mg/m 2 ; 24 h) + LV (200 mg/m 2 ; 30 min) ×4w followed by 2w rest; or combination of nal-IRI (80 mg/m 2 ; IV 90 min) prior to 5FU (2,400 mg/m 2 ; 46h) + LV (400 mg/m 2 ; 30min) q2w. Primary endpoint was OS. The ITT population included all randomized patients; the Per Protocol (PP) population included patients who received ≥80% of the target dose in the first 6 weeks and did not violate any in/ exclusion criteria. Results: Analysis of the PP populations confirmed the favorable OS of the combination nal-IRI+5FU/LV, which was also reflected by the PFS, ORR and CA19-9 levels. Median OS in the PP population for nal-IRI+5FU/ LV-arm was 8.9 m (n = 66) vs 5.1 m (n = 71) for 5FU/LV (unstratified HR = 0.57, log-rank test p = 0.011). The nal-IRI monotherapy arm did not show a statistically significant OS improvement over 5FU/LV. Analysis of subgroups, based on pretreatment characteristics including stage at diagnosis, time since initial histological diagnosis, prior lines of therapy, time since last prior therapy, and CA19-9, favored OS for the nal-IRI+5FU/ LV arm. Conclusions: Expanded analysis of the PP population and sensitivity analyses support the favorability of nal-IRI+5FU/LV over 5FU/LV, with amanageable safety profile