{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:21:06Z","timestamp":1787242866668,"version":"build-2736575974"},"reference-count":42,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,2,5]],"date-time":"2022-02-05T00:00:00Z","timestamp":1644019200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01CA212086"],"award-info":[{"award-number":["R01CA212086"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01CA212086\u201002"],"award-info":[{"award-number":["R01CA212086\u201002"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The 2020 National Comprehensive Cancer Network guidelines recommend neoadjuvant FOLFIRINOX or neoadjuvant gemcitabine plus nab\u2010paclitaxel (G\u2010nP) for borderline resectable\/locally advanced pancreatic ductal adenocarcinoma (BR\/LA PDAC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The purpose of our study was to compare treatment outcomes, toxicity profiles, costs, and quality\u2010of\u2010life measures between these two treatments to further inform clinical decision\u2010making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p>We developed a decision\u2010analytic mathematical model to compare the total cost and health outcomes of neoadjuvant FOLFIRINOX against G\u2010nP over 12\u2009years. The model inputs were estimated using clinical trial data and published literature. The primary endpoint was incremental cost\u2010effectiveness ratios (ICERs) with a willingness\u2010to\u2010pay threshold of $100\u2009000 per quality\u2010adjusted\u2010life\u2010year (QALY). Secondary endpoints included overall (OS) and progression\u2010free survival (PFS), total cost of care, QALYs, PDAC resection rate, and monthly treatment\u2010related adverse events (TRAE) costs (USD). FOLFIRINOX was the cost\u2010effective strategy, with an ICER of $60856.47 per QALY when compared to G\u2010nP. G\u2010nP had an ICER of $44639.71 per QALY when compared to natural history. For clinical outcomes, more patients underwent an \u201cR0\u201d resection with FOLFIRINOX compared to G\u2010nP (84.9 vs. 81.0%), but FOLFIRINOX had higher TRAE costs than G\u2010nP ($10905.19 vs. $4894.11). A one\u2010way sensitivity analysis found that the ICER of FOLFIRINOX exceeded the threshold when TRAE costs were higher or PDAC recurrence rates were lower.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our modeling analysis suggests that FOLFIRNOX is the cost\u2010effective treatment compared to G\u2010nP for BR\/LA PDAC despite having a higher cost of total care due to TRAE costs. Trial data with sufficient follow\u2010up are needed to confirm our findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cnr2.1565","type":"journal-article","created":{"date-parts":[[2022,2,5]],"date-time":"2022-02-05T03:39:40Z","timestamp":1644032380000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Cost\u2010effectiveness of neoadjuvant\n                    <scp>FOLFIRINOX<\/scp>\n                    versus gemcitabine plus nab\u2010paclitaxel in borderline resectable\/locally advanced pancreatic cancer patients"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9703-5805","authenticated-orcid":false,"given":"Myles A.","family":"Ingram","sequence":"first","affiliation":[{"name":"Division of General Medicine Columbia University Irving Medical Cancer and the Vagelos College of Physicians and Surgeons  New York New York 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