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Standard chemotherapy for metastatic pancreatic cancer is either the three-drug regimen FOLFIRINOX or the two-drug combination of gemcitabine and nab-paclitaxel. The regimens had not previously been compared head-to-head in a randomized trial.
Investigators now report results of NAPOLI 3, an industry-sponsored, open-label, multinational phase 3 trial evaluating first-line treatments for metastatic pancreatic cancer. Patients were randomized to treatment with either gemcitabine/nab-paclitaxel or NALIRIFOX — a modification of FOLFIRINOX that combines continuous infusion 5-FU, oxaliplatin, and liposomal irinotecan in place of irinotecan.
Of 770 patients, 67% had two or more sites of metastasis, 80% had liver metastases, 39% had primaries in the …