{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T19:10:02Z","timestamp":1772997002606,"version":"3.50.1"},"reference-count":21,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Nanoliposomal irinotecan (nal\u2010IRI) plus 5\u2010fluorouracil (5\u2010FU)\/\n                      <jats:italic>levo<\/jats:italic>\n                      \u2010leucovorin (\n                      <jats:italic>Levo<\/jats:italic>\n                      \u2010LV) therapy is recommended as the standard of care for unresectable locally advanced (UR\u2010LA) and metastatic pancreatic cancer after failure of gemcitabine\u2010containing regimens. Although the concomitant administration of nal\u2010IRI and\n                      <jats:italic>Levo<\/jats:italic>\n                      \u2010LV benefits from a reduced hospital stay, nal\u2010IRI is usually administered after\n                      <jats:italic>Levo<\/jats:italic>\n                      \u2010LV owing to insufficient data on compatibility reactions. This study aimed to compare the safety and efficacy of the sequential and concomitant administration of nal\u2010IRI and\n                      <jats:italic>Levo<\/jats:italic>\n                      \u2010LV.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data of patients with UR\u2010LA or metastatic pancreatic cancer who received nal\u2010IRI plus 5\u2010FU\/Levo\u2010LV between 2020 and 2023 at Shizuoka Cancer Center were retrospectively collected. Patients were classified into the sequential administration group (Group S) and concomitant administration group (Group C) to compare adverse events, infusion time, and survival. Univariate and multivariate analyses were performed to identify independent prognostic factors in each group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 94 patients were included (44 in Group S and 50 in Group C). There was no significant difference in the incidence of Grade 3 or higher adverse events between the two groups. The median total infusion times for nal\u2010IRI plus 5\u2010FU\/Levo\u2010LV in Groups S and C were 271 and 149\u2009min, respectively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Overall survival estimates were 5.6\u2009months (95% confidence interval [CI] 3.78\u20138.57) in Group S and 8.4\u2009months (95% CI 6.77\u201310.3) in Group C (unstratified HR 0.65, 95% CI 0.42\u20131.02;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.058). In the multivariate analysis for PFS and OS, the method of administration was not identified as an independent prognostic factor. Concomitant administration of\n                      <jats:italic>Levo<\/jats:italic>\n                      \u2010LV with nal\u2010IRI may not increase adverse events or impact efficacy while reducing infusion time.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Concomitant administration of\n                      <jats:italic>Levo<\/jats:italic>\n                      \u2010LV with nal\u2010IRI may not increase adverse events or impact efficacy compared to sequential administration.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cnr2.70485","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T04:38:19Z","timestamp":1770352699000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Safety and Efficacy of Concomitant Administration of Nanoliposomal Irinotecan + 5\u2010Fluorouracil\/\n                    <i>Levo<\/i>\n                    \u2010Leucovorin for Pancreatic Cancer"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-2478-3555","authenticated-orcid":false,"given":"Akane","family":"Wakabayashi","sequence":"first","affiliation":[{"name":"Department of Pharmacy Shizuoka Cancer Center  Sunto\u2010gun Shizuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7309-7374","authenticated-orcid":false,"given":"Rei","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Shizuoka Cancer Center  Sunto\u2010gun Shizuoka Japan"},{"name":"Department of Pharmacy Shonan University of Medical Sciences  Yokohama Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8774-8947","authenticated-orcid":false,"given":"Yurie","family":"Fukumuro","sequence":"additional","affiliation":[{"name":"Department of Nursing Shizuoka Cancer Center  Sunto\u2010gun Shizuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5473-1488","authenticated-orcid":false,"given":"Keita","family":"Mori","sequence":"additional","affiliation":[{"name":"Clinical Research Center Shizuoka Cancer Center  Sunto\u2010gun Shizuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2478-0190","authenticated-orcid":false,"given":"Junya","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Shonan University of Medical Sciences  Yokohama Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6478-7206","authenticated-orcid":false,"given":"Hiroshi","family":"Ishikawa","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Shizuoka Cancer Center  Sunto\u2010gun Shizuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4645-1118","authenticated-orcid":false,"given":"Michihiro","family":"Shino","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Shizuoka Cancer Center  Sunto\u2010gun Shizuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9385-9516","authenticated-orcid":false,"given":"Takeshi","family":"Kawakami","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal Oncology Shizuoka Cancer Center  Sunto\u2010gun Shizuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,5]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"e_1_2_13_3_1","unstructured":"Cancer statistics \u201cNational Cancer Center Japan: Cancer Information Service \u201d2024 (Vital Statistics of Japan Ministry of Health Labour and Welfare) https:\/\/ganjoho.jp\/public\/qa_links\/report\/statistics\/pdf\/cancer_statistics_2024_data_E.pdf."},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.2188\/jea.JE20220302"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/cas.15377"},{"key":"e_1_2_13_6_1","unstructured":"I. 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