Nanoliposomal irinotecan (Nal-IRI)-based chemotherapy after irinotecan -based chemotherapy in patients with pancreas cancer

Caleb J. Smith, Tanios S. Bekaii-Saab, Kathryn D. Cook, Rachel A. Eiring, Thorvardur R. Halfdanarson, Mina Hanna, Zhaohui Jin, Jacob A. Jochum, Wen Wee Ma, Jessica L. Mitchell, Henry C. Pitot, Aminah Jatoi

Research output: Contribution to journalArticlepeer-review


Background: Nanoliposomal irinotecan (Nal-IRI) is a preferred second-line treatment for metastatic pancreas cancer. It is unclear, however, whether patients who had received irinotecan derive benefit. Methods: Medical records of metastatic pancreas cancer patients who had received irinotecan and then Nal-IRI were reviewed. The primary endpoint was overall survival after the initiation of Nal-IRI (an a priori threshold of >4 months defined success); adverse events and quotes from the medical record on decision-making were also recorded. Results: Sixty four patients met eligibility criteria with a median age of 65 years (range: 36, 80 years). The median overall survival from initiation of Nal-IRI was 5.1 months (95% confidence interval (CI): 4.3, 5.6 months). An exploratory comparison, based on no cancer progression with irinotecan versus progression, showed improved survival with Nal-IRI in the former group: 6.1 months (95% CI: 5.1, 9.3 months) versus 4.3 months (95% CI: 2.3, 4.8 months); p = 0.0006. Nal-IRI adverse events occurred as expected. Qualitative data illustrate several themes, including “limited treatment options,” which appeared to drive the decision to prescribe Nal-IRI. Conclusion: Nal-IRI might be considered in pancreas cancer patients who had received irinotecan, particularly in the absence of disease progression with the latter.

Original languageEnglish (US)
Pages (from-to)379-383
Number of pages5
Issue number2
StatePublished - Mar 2021


  • Guidelines
  • Irinotecan
  • Liposomal
  • Pancreas cancer
  • Survival

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Gastroenterology


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