UMIN-CTR Clinical Trial

Unique ID issued by UMIN UMIN000048143
Receipt number R000054863
Scientific Title Comparison between nanoliposomal irinotecan plus 5-FU/ folinic acid and S-1 monotherapy in metastatic pancreatic cancer: A propensity score-matched retrospective cohort study.
Date of disclosure of the study information 2022/06/23
Last modified on 2025/06/24 11:12:31

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Basic information

Public title

Comparison between nanoliposomal irinotecan plus 5-FU/ folinic acid and S-1 monotherapy in metastatic pancreatic cancer: A propensity score-matched retrospective cohort study.

Acronym

Comparison between nanoliposomal irinotecan plus 5-FU/ folinic acid and S-1 monotherapy in metastatic pancreatic cancer: A propensity score-matched retrospective cohort study.

Scientific Title

Comparison between nanoliposomal irinotecan plus 5-FU/ folinic acid and S-1 monotherapy in metastatic pancreatic cancer: A propensity score-matched retrospective cohort study.

Scientific Title:Acronym

Comparison between nanoliposomal irinotecan plus 5-FU/ folinic acid and S-1 monotherapy in metastatic pancreatic cancer: A propensity score-matched retrospective cohort study.

Region

Japan


Condition

Condition

Pancreatic cancer

Classification by specialty

Hepato-biliary-pancreatic medicine

Classification by malignancy

Malignancy

Genomic information

NO


Objectives

Narrative objectives1

To compare the outcomes of the NAPOLI-1 regimen and S-1 monotherapy for recurrent or metastatic pancreatic cancer after gemcitabine-based first-line therapy

Basic objectives2

Efficacy

Basic objectives -Others


Trial characteristics_1

Confirmatory

Trial characteristics_2


Developmental phase

Not applicable


Assessment

Primary outcomes

Overall survival

Key secondary outcomes

Progression-free survival, Objective response rate, Disease control rate


Base

Study type

Observational


Study design

Basic design


Randomization


Randomization unit


Blinding


Control


Stratification


Dynamic allocation


Institution consideration


Blocking


Concealment



Intervention

No. of arms


Purpose of intervention


Type of intervention


Interventions/Control_1


Interventions/Control_2


Interventions/Control_3


Interventions/Control_4


Interventions/Control_5


Interventions/Control_6


Interventions/Control_7


Interventions/Control_8


Interventions/Control_9


Interventions/Control_10



Eligibility

Age-lower limit

20 years-old <=

Age-upper limit


Not applicable

Gender

Male and Female

Key inclusion criteria

1) NAPOLI-1 regimen or S-1 monotherapy is initiated as second-line therapy after failure of gemcitabine=based first-line therapy.
2) Therapy is introduced between September 1, 2019 and February 28, 2021
3) Diagnosis of adenocarcinoma by histological or cytological diagnosis of primary or metastatic lesions.
4) Pancreatic cancer with distant metastasis or recurrent pancreatic cancer by chest CT and abdominal/pelvic contrast-enhanced CT or abdominal/pelvic contrast-enhanced MRI.
In the case of recurrent pancreatic cancer, the following items should be followed:
a) The first treatment regimen after the diagnosis of recurrence is considered as the primary treatment.
b) If postoperative adjuvant chemotherapy was administered, patients are eligible if at least 6 months have elapsed between the last administration of postoperative adjuvant chemotherapy and the recurrence (patients are eligible if the recurrence occurs on the same date 6 months after the last administration of postoperative adjuvant chemotherapy).
c) The first treatment regimen after the diagnosis of recurrence is defined as first-line treatment.
5) Patients must not have used irinotecan (including nanoliposomal irinotecan) or fluoropyrimidines.
6) Patients must be at least 20 years of age at the time of enrollment.

Key exclusion criteria

None

Target sample size

500


Research contact person

Name of lead principal investigator

1st name Masafumi
Middle name
Last name Ikeda

Organization

National Cancer Center Hospital East

Division name

Hepatobiliary and Pancreatic Oncology

Zip code

277-8577

Address

6-5-1, Kashiwanoha, Kashiwa

TEL

+81-4-7133-1111

Email

masikeda@east.ncc.go.jp


Public contact

Name of contact person

1st name Hiroshi
Middle name
Last name Imaoka

Organization

National Cancer Center Hospital East

Division name

Hepatobiliary and Pancreatic Oncology

Zip code

277-8577

Address

6-5-1, Kashiwanoha, Kashiwa

TEL

+81-4-7133-1111

Homepage URL


Email

hiimaoka@east.ncc.go.jp


Sponsor or person

Institute

Japan Oncology Network in Hepatobiliary and Pancreas

Institute

Department

Personal name



Funding Source

Organization

Japan Oncology Network in Hepatobiliary and Pancreas

Organization

Division

Category of Funding Organization

Non profit foundation

Nationality of Funding Organization



Other related organizations

Co-sponsor


Name of secondary funder(s)



IRB Contact (For public release)

Organization

Ethics Review Board of National Cancer Center

Address

5-1-1, Tsukiji, Chuo-ku

Tel

+81-3-3542-2511

Email

NCC_IRBoffice@ml.res.ncc.go.jp


Secondary IDs

Secondary IDs

YES

Study ID_1

2022-045

Org. issuing International ID_1

Ethics Review Board of National Cancer Center

Study ID_2

JON2109-P

Org. issuing International ID_2

Japan Oncology Network in Hepatobiliary and Pancreas

IND to MHLW



Institutions

Institutions



Other administrative information

Date of disclosure of the study information

2022 Year 06 Month 23 Day


Related information

URL releasing protocol

Not applicable

Publication of results

Published


Result

URL related to results and publications

https://link.springer.com/article/10.1007/s00535-024-02186-9#additional-information

Number of participants that the trial has enrolled

463

Results

A total of 463 metastatic PC patients were enrolled in this study (257 in the S-1 monotherapy group and 206 in the nal-IRI + 5-FU/LV group). The median OS was 7.50 months (95% CI 4.18-12.69 months) in the nal-IRI + 5-FU/LV group and 5.72 months (95% CI 2.76-10.79 months) in the S-1 monotherapy group. In the IPTW-adjusted Cox proportional hazards model, nal-IRI + 5-FU/LV was associated with a significant OS benefit (pooled IPTW-adjusted hazard ratio, 0.779; 95% CI 0.399-0.941; p = 0.025).

Results date posted

2025 Year 06 Month 24 Day

Results Delayed


Results Delay Reason


Date of the first journal publication of results


Baseline Characteristics

S-1 tended to be given to patients with poor performance status (PS) and moderate or more ascites. In contrast, nal-IRI + 5-FU/LV tended to be given to patients with younger age and liver metastasis. The propensity score distribution between the treatment groups showed covariate imbalance before IPTW adjustment (Supplementary Fig. 1). Standardized mean differences of unadjusted comparisons showed potential imbalances between both treatment groups with respect to many clinical characteristics of interest (e.g., age and Eastern Cooperative Oncology Group PS).

Participant flow

A total of 463 metastatic PC patients were enrolled in this study (206 in the nal-IRI + 5-FU/LV group, and 257 in the S-1 group). The full-cohort data consisted of 463 patients with metastatic PC, whereas the complete-case dataset consisted of 446 patients.

Adverse events

Not applicable.

Outcome measures

The main objective of this study was to compare OS using the inverse probability of treatment weighting (IPTW) method in patients treated with nal-IRI + 5-FU/LV and those treated with S-1 monotherapy. The secondary objectives were to compare progression-free survival (PFS) using the IPTW method and tumor response in patients treated with nal-IRI + 5-FU/LV and those treated with S-1.

Plan to share IPD


IPD sharing Plan description



Progress

Recruitment status

Completed

Date of protocol fixation

2022 Year 04 Month 21 Day

Date of IRB

2022 Year 06 Month 23 Day

Anticipated trial start date

2022 Year 06 Month 23 Day

Last follow-up date

2023 Year 09 Month 25 Day

Date of closure to data entry

2023 Year 09 Month 25 Day

Date trial data considered complete

2023 Year 09 Month 25 Day

Date analysis concluded

2024 Year 04 Month 20 Day


Other

Other related information

Retrospective cohort study


Management information

Registered date

2022 Year 06 Month 23 Day

Last modified on

2025 Year 06 Month 24 Day



Link to view the page

Value
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000054863