NAPOLI-3 in Real World Practice: Expert Insights on Data From ASCO GI 2025
Panelists discuss how real-world retrospective data from the Flatiron Health Database showed median overall survival of approximately 9 months for FOLFIRINOX-treated patients, which appears numerically lower than NALIRIFOX results, though these findings require cautious interpretation due to the non-randomized nature of the comparison.
EP: 1.First-Line Treatment Options for Metastatic Pancreatic Adenocarcinoma
EP: 2.Insights From The NAPOLI-3 and PRODIGE4 Trials In Metastatic Pancreatic Adenocarcinoma
EP: 3.Managing AEs Associated With the FOLFIRINOX and NALIRIFOX Regimens in Pancreatic Cancer
EP: 4.NAPOLI-3 in Real World Practice: Expert Insights on Data From ASCO GI 2025
EP: 5.Evaluating the Impact Of UGT1A1*28 Status On Tolerability Of NALIRIFOX In mPDAC
EP: 6.NALIRIFOX In Practice: Treatment Strategies for Patients With mPDAC
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Dr. Chandana reviews a retrospective study presented at ASCO GI 2025 by Paul Cochram et al., which analyzed real-world outcomes for patients with metastatic pancreatic adenocarcinoma treated with FOLFIRINOX or modified FOLFIRINOX. Using the Flatiron Health Database, researchers examined three cohorts: all adult metastatic pancreatic cancer patients treated with first-line FOLFIRINOX from January 2014 to January 2022; a trial-aligned cohort of patients treated with FOLFIRINOX between January 2020 and July 2022 (coinciding with the NAPOLI-3 study period); and patients who received modified FOLFIRINOX during the same time frame.
The analysis included 3,200 patients in the comprehensive cohort with a median age of 63 years, 42% female representation, and 48.9% having ECOG performance status of 1. The median overall survival for this group was 9 months. The trial-aligned cohort comprised 219 patients with a median survival of 9.1 months (range: 7.8-10.9 months). The third cohort of 154 patients treated with modified FOLFIRINOX during the NAPOLI-3 study period showed a median overall survival of 8.6 months (range: 7.3-10.5 months).
Dr. Chandana emphasizes that while this real-world data suggests NALIRIFOX showed numerically improved overall survival compared to FOLFIRINOX or modified FOLFIRINOX (with median overall survival around 9 months across cohorts), the results should be interpreted cautiously as this was not a randomized comparison. He notes the limitations of retrospective analyses and suggests that further studies adjusting for baseline characteristics are warranted to provide more definitive insights into comparative effectiveness.
Prolaris in Practice: Guiding ADT Benefits, Clinical Application, and Expert Insights From ACRO 2025
April 15th 2025Steven E. Finkelstein, MD, DABR, FACRO discuses how Prolaris distinguishes itself from other genomic biomarker platforms by providing uniquely actionable clinical information that quantifies the absolute benefit of androgen deprivation therapy when added to radiation therapy, offering clinicians a more precise tool for personalizing prostate cancer treatment strategies.
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