Survival after neoadjuvant and induction FOLFIRINOX versus gemcitabine-nab-paclitaxel in patients with resected localised pancreatic adenocarcinoma: an international multicentre study

Thomas F Stoop; Y H Andrew Wu; Atsushi Oba; Mahsoem Ali; Isabel M Feld; Mohammed H Al-Musawi; Ajay Jain; Akio Saiura; Alain Sauvanet; Alessandro Coppola; Ammar A Javed; Bas Groot Koerkamp; Braden N Miller; Daisuke Hashimoto; Damiano Caputo; Dyre Kleive; Elisabetta Sereni; Geert Kazemier; Giulio Belfiori; Hirofumi Ishida; Jacob L van Dam; Jeanne Dembinski; Keiichi Akahoshi; Keith J Roberts; Kimitaka Tanaka; Knut J Labori; Massimo Falconi; Michael G House; Motokazu Sugimoto; Minoru Tanabe; Naoto Gotohda; Nikolaos Chatzizacharias; Paul S Krohn; Safi Dokmak; Salvador Rodriguez Franco; Satoshi Hirano; Stefan K Burgdorf; Stefano Crippa; Sohei Satoi; Trang K Nguyen; Tomohisa Yamamoto; Toru Nakamura; Yuta Ushida; Vismaya Bachu; William R Burns; Yosuke Inoue; Yu Takahashi; Zohra Aslami; Richard D Schulick; Jin He; International Consortium on Pancreatic Cancer Surgery and Oncology (ICON)

doi:10.1038/s41416-025-03025-1

Survival after neoadjuvant and induction FOLFIRINOX versus gemcitabine-nab-paclitaxel in patients with resected localised pancreatic adenocarcinoma: an international multicentre study

Thomas F Stoop^*, Y H Andrew Wu, Atsushi Oba, Mahsoem Ali, Isabel M Feld, Mohammed H Al-Musawi, Ajay Jain, Akio Saiura, Alain Sauvanet, Alessandro Coppola, Ammar A Javed, Bas Groot Koerkamp, Braden N Miller, Daisuke Hashimoto, Damiano Caputo, Dyre Kleive, Elisabetta Sereni, Geert Kazemier, Giulio Belfiori, Hirofumi IshidaJacob L van Dam, Jeanne Dembinski, Keiichi Akahoshi, Keith J Roberts, Kimitaka Tanaka, Knut J Labori, Massimo Falconi, Michael G House, Motokazu Sugimoto, Minoru Tanabe, Naoto Gotohda, Nikolaos Chatzizacharias, Paul S Krohn, Safi Dokmak, Salvador Rodriguez Franco, Satoshi Hirano, Stefan K Burgdorf, Stefano Crippa, Sohei Satoi, Trang K Nguyen, Tomohisa Yamamoto, Toru Nakamura, Yuta Ushida, Vismaya Bachu, William R Burns, Yosuke Inoue, Yu Takahashi, Zohra Aslami, Richard D Schulick, Jin He, International Consortium on Pancreatic Cancer Surgery and Oncology (ICON)

^*Corresponding author for this work

Department of Transplantation and Digestive Diseases

4 Citations (Scopus)

Abstract

BACKGROUND: It remains unclear whether there is a difference in overall survival (OS) benefit between (m)FOLFIRINOX and gemcitabine-nab-paclitaxel as preoperative regimens for localised pancreatic adenocarcinoma. This study aimed to investigate the outcome of patients with resected localised pancreatic adenocarcinoma following (m)FOLFIRINOX versus gemcitabine-nab-paclitaxel.

METHODS: International multicentre retrospective study (16 centres, 8 countries, 3 continents), including consecutive patients after pancreatic resection for localised pancreatic adenocarcinoma following 2-6 months preoperative (m)FOLFIRINOX or gemcitabine-nab-paclitaxel (2010-2018). Primary endpoint was OS from start of preoperative chemotherapy. Cox regression analysis was performed to investigate the association of the preoperative chemotherapy regimen with OS, adjusted for confounders at diagnosis.

RESULTS: Overall, 935 patients were included after resection of localised pancreatic adenocarcinoma following preoperative (m)FOLFIRINOX (65%) or gemcitabine-nab-paclitaxel (35%). Preoperative chemotherapy regimen (m)FOLFIRINOX was not associated with OS (HR = 0.83 [95% CI 0.64-1.08]), compared to gemcitabine-nab-paclitaxel. Interaction analysis showed stronger effect of (m)FOLFIRINOX in patients with a lower (i.e., non-elevated/marginally elevated) serum CA19-9 at diagnosis (pinteraction = 0.032).

CONCLUSION: This international study found no OS benefit of preoperative (m)FOLFIRINOX in patients with resected localised pancreatic adenocarcinoma compared to gemcitabine-nab-paclitaxel.

Original language	English
Journal	British Journal of Cancer
Volume	133
Issue number	1
Pages (from-to)	76-84
Number of pages	9
ISSN	0007-0920
DOIs	https://doi.org/10.1038/s41416-025-03025-1
Publication status	Published - Jul 2025

Keywords

Humans
Pancreatic Neoplasms/drug therapy
Paclitaxel/administration & dosage
Female
Deoxycytidine/analogs & derivatives
Male
Antineoplastic Combined Chemotherapy Protocols/therapeutic use
Gemcitabine
Middle Aged
Aged
Albumins/administration & dosage
Adenocarcinoma/drug therapy
Retrospective Studies
Fluorouracil/therapeutic use
Neoadjuvant Therapy/methods
Leucovorin/therapeutic use
Irinotecan/therapeutic use
Oxaliplatin/therapeutic use
Adult

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10.1038/s41416-025-03025-1

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Stoop, T. F., Wu, Y. H. A., Oba, A., Ali, M., Feld, I. M., Al-Musawi, M. H., Jain, A., Saiura, A., Sauvanet, A., Coppola, A., Javed, A. A., Groot Koerkamp, B., Miller, B. N., Hashimoto, D., Caputo, D., Kleive, D., Sereni, E., Kazemier, G., Belfiori, G., ... International Consortium on Pancreatic Cancer Surgery and Oncology (ICON) (2025). Survival after neoadjuvant and induction FOLFIRINOX versus gemcitabine-nab-paclitaxel in patients with resected localised pancreatic adenocarcinoma: an international multicentre study. British Journal of Cancer, 133(1), 76-84. https://doi.org/10.1038/s41416-025-03025-1

Survival after neoadjuvant and induction FOLFIRINOX versus gemcitabine-nab-paclitaxel in patients with resected localised pancreatic adenocarcinoma: an international multicentre study. / Stoop, Thomas F; Wu, Y H Andrew; Oba, Atsushi et al.
In: British Journal of Cancer, Vol. 133, No. 1, 07.2025, p. 76-84.

Research output: Contribution to journal › Journal article › Research › peer-review

Stoop, TF, Wu, YHA, Oba, A, Ali, M, Feld, IM, Al-Musawi, MH, Jain, A, Saiura, A, Sauvanet, A, Coppola, A, Javed, AA, Groot Koerkamp, B, Miller, BN, Hashimoto, D, Caputo, D, Kleive, D, Sereni, E, Kazemier, G, Belfiori, G, Ishida, H, van Dam, JL, Dembinski, J, Akahoshi, K, Roberts, KJ, Tanaka, K, Labori, KJ, Falconi, M, House, MG, Sugimoto, M, Tanabe, M, Gotohda, N, Chatzizacharias, N, Krohn, PS, Dokmak, S, Rodriguez Franco, S, Hirano, S, Burgdorf, SK, Crippa, S, Satoi, S, Nguyen, TK, Yamamoto, T, Nakamura, T, Ushida, Y, Bachu, V, Burns, WR, Inoue, Y, Takahashi, Y, Aslami, Z, Schulick, RD, He, J & International Consortium on Pancreatic Cancer Surgery and Oncology (ICON) 2025, 'Survival after neoadjuvant and induction FOLFIRINOX versus gemcitabine-nab-paclitaxel in patients with resected localised pancreatic adenocarcinoma: an international multicentre study', British Journal of Cancer, vol. 133, no. 1, pp. 76-84. https://doi.org/10.1038/s41416-025-03025-1

@article{bec7bffe4d8841b1be8fc69720d0e687,

title = "Survival after neoadjuvant and induction FOLFIRINOX versus gemcitabine-nab-paclitaxel in patients with resected localised pancreatic adenocarcinoma: an international multicentre study",

abstract = "BACKGROUND: It remains unclear whether there is a difference in overall survival (OS) benefit between (m)FOLFIRINOX and gemcitabine-nab-paclitaxel as preoperative regimens for localised pancreatic adenocarcinoma. This study aimed to investigate the outcome of patients with resected localised pancreatic adenocarcinoma following (m)FOLFIRINOX versus gemcitabine-nab-paclitaxel.METHODS: International multicentre retrospective study (16 centres, 8 countries, 3 continents), including consecutive patients after pancreatic resection for localised pancreatic adenocarcinoma following 2-6 months preoperative (m)FOLFIRINOX or gemcitabine-nab-paclitaxel (2010-2018). Primary endpoint was OS from start of preoperative chemotherapy. Cox regression analysis was performed to investigate the association of the preoperative chemotherapy regimen with OS, adjusted for confounders at diagnosis.RESULTS: Overall, 935 patients were included after resection of localised pancreatic adenocarcinoma following preoperative (m)FOLFIRINOX (65\%) or gemcitabine-nab-paclitaxel (35\%). Preoperative chemotherapy regimen (m)FOLFIRINOX was not associated with OS (HR = 0.83 [95\% CI 0.64-1.08]), compared to gemcitabine-nab-paclitaxel. Interaction analysis showed stronger effect of (m)FOLFIRINOX in patients with a lower (i.e., non-elevated/marginally elevated) serum CA19-9 at diagnosis (pinteraction = 0.032).CONCLUSION: This international study found no OS benefit of preoperative (m)FOLFIRINOX in patients with resected localised pancreatic adenocarcinoma compared to gemcitabine-nab-paclitaxel.",

keywords = "Humans, Pancreatic Neoplasms/drug therapy, Paclitaxel/administration \& dosage, Female, Deoxycytidine/analogs \& derivatives, Male, Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Gemcitabine, Middle Aged, Aged, Albumins/administration \& dosage, Adenocarcinoma/drug therapy, Retrospective Studies, Fluorouracil/therapeutic use, Neoadjuvant Therapy/methods, Leucovorin/therapeutic use, Irinotecan/therapeutic use, Oxaliplatin/therapeutic use, Adult",

author = "Stoop, \{Thomas F\} and Wu, \{Y H Andrew\} and Atsushi Oba and Mahsoem Ali and Feld, \{Isabel M\} and Al-Musawi, \{Mohammed H\} and Ajay Jain and Akio Saiura and Alain Sauvanet and Alessandro Coppola and Javed, \{Ammar A\} and \{Groot Koerkamp\}, Bas and Miller, \{Braden N\} and Daisuke Hashimoto and Damiano Caputo and Dyre Kleive and Elisabetta Sereni and Geert Kazemier and Giulio Belfiori and Hirofumi Ishida and \{van Dam\}, \{Jacob L\} and Jeanne Dembinski and Keiichi Akahoshi and Roberts, \{Keith J\} and Kimitaka Tanaka and Labori, \{Knut J\} and Massimo Falconi and House, \{Michael G\} and Motokazu Sugimoto and Minoru Tanabe and Naoto Gotohda and Nikolaos Chatzizacharias and Krohn, \{Paul S\} and Safi Dokmak and \{Rodriguez Franco\}, Salvador and Satoshi Hirano and Burgdorf, \{Stefan K\} and Stefano Crippa and Sohei Satoi and Nguyen, \{Trang K\} and Tomohisa Yamamoto and Toru Nakamura and Yuta Ushida and Vismaya Bachu and Burns, \{William R\} and Yosuke Inoue and Yu Takahashi and Zohra Aslami and Schulick, \{Richard D\} and Jin He and \{International Consortium on Pancreatic Cancer Surgery and Oncology (ICON)\}",

note = "{\textcopyright} 2025. The Author(s), under exclusive licence to Springer Nature Limited.",

year = "2025",

month = jul,

doi = "10.1038/s41416-025-03025-1",

language = "English",

volume = "133",

pages = "76--84",

journal = "British Journal of Cancer",

issn = "0007-0920",

publisher = "Nature Publishing Group",

number = "1",

}

TY - JOUR

T1 - Survival after neoadjuvant and induction FOLFIRINOX versus gemcitabine-nab-paclitaxel in patients with resected localised pancreatic adenocarcinoma

T2 - an international multicentre study

AU - Stoop, Thomas F

AU - Wu, Y H Andrew

AU - Oba, Atsushi

AU - Ali, Mahsoem

AU - Feld, Isabel M

AU - Al-Musawi, Mohammed H

AU - Jain, Ajay

AU - Saiura, Akio

AU - Sauvanet, Alain

AU - Coppola, Alessandro

AU - Javed, Ammar A

AU - Groot Koerkamp, Bas

AU - Miller, Braden N

AU - Hashimoto, Daisuke

AU - Caputo, Damiano

AU - Kleive, Dyre

AU - Sereni, Elisabetta

AU - Kazemier, Geert

AU - Belfiori, Giulio

AU - Ishida, Hirofumi

AU - van Dam, Jacob L

AU - Dembinski, Jeanne

AU - Akahoshi, Keiichi

AU - Roberts, Keith J

AU - Tanaka, Kimitaka

AU - Labori, Knut J

AU - Falconi, Massimo

AU - House, Michael G

AU - Sugimoto, Motokazu

AU - Tanabe, Minoru

AU - Gotohda, Naoto

AU - Chatzizacharias, Nikolaos

AU - Krohn, Paul S

AU - Dokmak, Safi

AU - Rodriguez Franco, Salvador

AU - Hirano, Satoshi

AU - Burgdorf, Stefan K

AU - Crippa, Stefano

AU - Satoi, Sohei

AU - Nguyen, Trang K

AU - Yamamoto, Tomohisa

AU - Nakamura, Toru

AU - Ushida, Yuta

AU - Bachu, Vismaya

AU - Burns, William R

AU - Inoue, Yosuke

AU - Takahashi, Yu

AU - Aslami, Zohra

AU - Schulick, Richard D

AU - He, Jin

AU - International Consortium on Pancreatic Cancer Surgery and Oncology (ICON)

PY - 2025/7

Y1 - 2025/7

N2 - BACKGROUND: It remains unclear whether there is a difference in overall survival (OS) benefit between (m)FOLFIRINOX and gemcitabine-nab-paclitaxel as preoperative regimens for localised pancreatic adenocarcinoma. This study aimed to investigate the outcome of patients with resected localised pancreatic adenocarcinoma following (m)FOLFIRINOX versus gemcitabine-nab-paclitaxel.METHODS: International multicentre retrospective study (16 centres, 8 countries, 3 continents), including consecutive patients after pancreatic resection for localised pancreatic adenocarcinoma following 2-6 months preoperative (m)FOLFIRINOX or gemcitabine-nab-paclitaxel (2010-2018). Primary endpoint was OS from start of preoperative chemotherapy. Cox regression analysis was performed to investigate the association of the preoperative chemotherapy regimen with OS, adjusted for confounders at diagnosis.RESULTS: Overall, 935 patients were included after resection of localised pancreatic adenocarcinoma following preoperative (m)FOLFIRINOX (65%) or gemcitabine-nab-paclitaxel (35%). Preoperative chemotherapy regimen (m)FOLFIRINOX was not associated with OS (HR = 0.83 [95% CI 0.64-1.08]), compared to gemcitabine-nab-paclitaxel. Interaction analysis showed stronger effect of (m)FOLFIRINOX in patients with a lower (i.e., non-elevated/marginally elevated) serum CA19-9 at diagnosis (pinteraction = 0.032).CONCLUSION: This international study found no OS benefit of preoperative (m)FOLFIRINOX in patients with resected localised pancreatic adenocarcinoma compared to gemcitabine-nab-paclitaxel.

AB - BACKGROUND: It remains unclear whether there is a difference in overall survival (OS) benefit between (m)FOLFIRINOX and gemcitabine-nab-paclitaxel as preoperative regimens for localised pancreatic adenocarcinoma. This study aimed to investigate the outcome of patients with resected localised pancreatic adenocarcinoma following (m)FOLFIRINOX versus gemcitabine-nab-paclitaxel.METHODS: International multicentre retrospective study (16 centres, 8 countries, 3 continents), including consecutive patients after pancreatic resection for localised pancreatic adenocarcinoma following 2-6 months preoperative (m)FOLFIRINOX or gemcitabine-nab-paclitaxel (2010-2018). Primary endpoint was OS from start of preoperative chemotherapy. Cox regression analysis was performed to investigate the association of the preoperative chemotherapy regimen with OS, adjusted for confounders at diagnosis.RESULTS: Overall, 935 patients were included after resection of localised pancreatic adenocarcinoma following preoperative (m)FOLFIRINOX (65%) or gemcitabine-nab-paclitaxel (35%). Preoperative chemotherapy regimen (m)FOLFIRINOX was not associated with OS (HR = 0.83 [95% CI 0.64-1.08]), compared to gemcitabine-nab-paclitaxel. Interaction analysis showed stronger effect of (m)FOLFIRINOX in patients with a lower (i.e., non-elevated/marginally elevated) serum CA19-9 at diagnosis (pinteraction = 0.032).CONCLUSION: This international study found no OS benefit of preoperative (m)FOLFIRINOX in patients with resected localised pancreatic adenocarcinoma compared to gemcitabine-nab-paclitaxel.

KW - Humans

KW - Pancreatic Neoplasms/drug therapy

KW - Paclitaxel/administration & dosage

KW - Female

KW - Deoxycytidine/analogs & derivatives

KW - Male

KW - Antineoplastic Combined Chemotherapy Protocols/therapeutic use

KW - Gemcitabine

KW - Middle Aged

KW - Aged

KW - Albumins/administration & dosage

KW - Adenocarcinoma/drug therapy

KW - Retrospective Studies

KW - Fluorouracil/therapeutic use

KW - Neoadjuvant Therapy/methods

KW - Leucovorin/therapeutic use

KW - Irinotecan/therapeutic use

KW - Oxaliplatin/therapeutic use

KW - Adult

UR - https://www.scopus.com/pages/publications/105010889743

U2 - 10.1038/s41416-025-03025-1

DO - 10.1038/s41416-025-03025-1

M3 - Journal article

C2 - 40328917

SN - 0007-0920

VL - 133

SP - 76

EP - 84

JO - British Journal of Cancer

JF - British Journal of Cancer

IS - 1

ER -

Survival after neoadjuvant and induction FOLFIRINOX versus gemcitabine-nab-paclitaxel in patients with resected localised pancreatic adenocarcinoma: an international multicentre study

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