Introduction: Metastatic pancreatic cancer continues to carry a dismal prognosis, with limited effective options after failure of first-line gemcitabine-based therapy. Liposomal irinotecan (nal-IRI) combined with 5-fluorouracil/leucovorin (5-FU/LV) is currently an established second-line standard.
Introduction:
Metastatic pancreatic cancer continues to carry a dismal prognosis, with limited effective options after failure of first-line gemcitabine-based therapy. Liposomal irinotecan (nal-IRI) combined with 5-fluorouracil/leucovorin (5-FU/LV) is currently an established second-line standard. However, S-1, an oral fluoropyrimidine widely used in Asian populations, has shown promising efficacy and convenience, raising the possibility of an alternative combination strategy with nal-IRI.
Problem Statement and Summary:
The NAPAN trial was designed to evaluate whether nal-IRI plus S-1 could outperform the current standard nal-IRI plus 5-FU/LV in second-line treatment. However, the study failed to demonstrate superiority, with shorter progression-free survival and a trend toward inferior overall survival in the S-1 arm. While toxicity profiles were comparable, no clinical advantage was observed with S-1. These findings reinforce nal-IRI plus 5-FU/LV as the standard second-line regimen and highlight the ongoing challenge of improving outcomes in metastatic pancreatic cancer beyond current chemotherapy backbones.
Introduction: Advanced biliary tract cancer (BTC) carries a poor prognosis, with limited improvements in survival despite the addition of immune checkpoint inhibitors to standard gemcitabine–cisplatin chemotherapy. This phase II trial evaluated ivonescimab, a novel PD-1/VEGF...
Introduction: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have become a cornerstone in the management of type 2 diabetes because of their excellent glycemic, cardiovascular, and weight-loss benefits. However, concerns remain regarding their potential association with...
Introduction: Patients undergoing pancreatoduodenectomy for non invasive intraductal papillary mucinous neoplasm (IPMN) require long-term surveillance because of the risk of disease recurrence in the pancreatic remnant. New pancreatic duct (PD) dilatation is commonly detected during...
• This study evaluated 1,063 patients undergoing pancreatic surgery; 11% developed conventionally defined chyle leak. • Most clinically relevant cases were grade B, while no grade C leaks were reported. • A minimally invasive surgical...
Introduction: Endoscopic ultrasound (EUS)-guided drainage has become the preferred minimally invasive treatment for symptomatic necrotizing pancreatitis. However, the optimal timing of direct endoscopic necrosectomy (DEN) following drainage remains uncertain. While the conventional step-up approach reserves...
Introduction: Fatty pancreas disease (FPD), also known as intrapancreatic fat deposition, has emerged as an important metabolic condition closely linked to obesity, insulin resistance, and type 2 diabetes mellitus (T2DM). Although ectopic fat accumulation in...
We are pioneers in clinical intelligence, dedicated to helping gastroenterologists harness the power of artificial intelligence to drive precision, efficiency, and patient growth.