Loading
Life sciences · Journal article
Journal of Surgical Oncology · October 12, 2026
No summary has been generated for this record yet. What follows is drawn from its source metadata only.
Journal article.
No findings were extractable from the material analysed.
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
The source did not state who this applies to in practice.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
This record has not been graded across any dimension yet. Treat the label above as provisional and read the source.
What is missing. This record has no bottom line, key findings, reported figures, evidence dimensions. That is a gap in the analysis, not a judgement about the study.
INTRODUCTION: The PRODIGE 24/CCTG PA.6- trial has shown an overall survival (OS) up to 55 months in patients treated with (modified) 5-fluorouracil, leucovorin, irinotecan and oxaliplatin ((m)FOLFIRINOX) chemotherapy after resection of pancreatic ductal adenocarcinoma (PDAC). The applicability of these results to a real-world patient population is, however, unknown. This study aimed to assess the efficacy of (m)FOLFIRINOX compared to other adjuvant chemotherapy regimens in a real-world cohort. METHODS: We performed a post-hoc analysis in a prospectively maintained cohort of patients undergoing PDAC resection in the Regional Academic Cancer Centre Utrecht, the Netherlands, from 2016 to 2020. Median OS was evaluated using Kaplan-Meier curves, primarily stratified by adjuvant chemotherapy regimen and secondarily by eligibility for the PRODIGE 24/CCTG PA.6- trial. Multivariable Cox regression was used to assess the association between chemotherapy regimen and OS, presented as hazard ratio's (HR) with 95% confidence interval (95%CI). RESULTS: A total of 161 patients with a median follow-up of 51 months (interquartile range (IQR) 43-61) were included. With (m)FOLFIRINOX (n = 30), OS was 29 months (IQR 22-42; [HR 0.26, 95%CI 0.14-0.47, p < 0.01]). Comparing (m)FOLFIRINOX with gemcitabine monotherapy yielded a HR of 0.62 (95%CI 0.33-1.17, p = 0.14), while (m)FOLFIRINOX versus gemcitabine combination therapy had a HR of 0.66 (95% CI 0.35-1.24 p = 0.20). Patients without adjuvant therapy (n = 71) had a median OS of 13 months (IQR 11-23, reference group). In patients receiving gemcitabine monotherapy (n = 31), median OS was 21 months (IQR 15-31; [HR 0.41 95%CI 0.25-0.69, p < 0.01]); for gemcitabine combination therapy (n = 29), OS was 28 months (IQR 23-43; [HR 0.39, 95%CI 0.23-0.66, p < 0.01]) In patients who received (m)FOLFIRINOX and who did or did not meet trial eligibility criteria, OS was 27 months (IQR 12-NR), compared to 30 months (IQR 21-NR) (p = 0.16), respectively. CONCLUSION: The survival benefit of (m)FOLFIRINOX observed in the clinical trial setting was not observed in our real-world cohort, not even in the selected subset of patients who would have deemed eligible for inclusion in the PRODIGE 24/CCTG PA.6- trial. Survival was not different for patients treated with (m)FOLFIRINOX and gemcitabine combination therapy.