Dr. Patel on a Subgroup Analysis of the NAPOLI-1 Trial in Pancreatic Cancer

Reema A. Patel, MD, associate program director, Hematology & Medical Oncology Fellowship, assistant professor of medicine, Division of Medical Oncology, University of Kentucky, discusses the results of a subgroup analysis from the NAPOLI-1 trial in pancreatic cancer.

The phase 3 NAPOLI-1 trial demonstrated a survival benefit with liposomal irinotecan (Onivyde) in combination with 5-fluorouracil (5-FU) and leucovorin versus 5-FU and leucovorin alone in patients with metastatic pancreatic ductal adenocarcinoma who had received prior gemcitabine-based therapy.

A post-hoc subgroup analysis revealed that the majority of patient subgroups responded well to the treatment, Patel explains. However, patients who received prior non-liposomal irinotecan had poorer outcomes versus patients who had no prior irinotecan. Notably, due to the low number of patients who had prior non-liposomal irinotecan, these findings may not be widely applicable in the real-world setting, Patel says.

However, in practice, it may be optimal to give an alternative therapy between non-liposomal irinotecan and liposomal irinotecan to potentially increase the chance of response to liposomal irinotecan, concludes Patel.