Evaluating Chemotherapy Regimens in Advanced Pancreatic Cancer: A Comprehensive Meta-Analysis

A recent systematic review and Bayesian network meta-analysis published in Lancet Oncology compared various first-line chemotherapy regimens for patients with unresectable, locally advanced or metastatic pancreatic ductal adenocarcinoma (PDAC). Analyzing data from 79 randomized controlled trials involving 22,168 patients, researchers identified gemcitabine plus nab-paclitaxel alternating with FOLFOX, PAXG, and NALIRIFOX as the most effective treatments, significantly improving progression-free and overall survival compared to traditional treatments. FOLFIRINOX and gemcitabine plus nab-paclitaxel also demonstrated notable effectiveness. These findings suggest that NALIRIFOX and FOLFIRINOX should be considered the preferred options for patients able to tolerate intensive treatments, whereas gemcitabine plus nab-paclitaxel remains a viable alternative for patients less suited to aggressive therapies. Further clinical trials exploring combined and sequential therapy approaches are recommended.