{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T12:10:23Z","timestamp":1790079023774,"version":"4.0.1"},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"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":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The optimal second\u2010line chemotherapy after gemcitabine plus nab\u2010paclitaxel (GnP) for unresectable pancreatic cancer (PC) remains unclear. This study compared the efficacy and safety of nanoliposomal irinotecan plus fluorouracil\/leucovorin (NFF) and S\u20101, irinotecan, and oxaliplatin (S\u2010IROX) after GnP failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single\u2010center retrospective cohort study included patients with unresectable PC refractory to GnP who received NFF or S\u2010IROX between July 2020 and June 2024. Progression\u2010free survival (PFS), overall survival (OS), tumor response, and adverse events were evaluated. Prognostic factors were also assessed with subgroup analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seventy\u2010nine patients were analyzed (NFF,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200955; S\u2010IROX,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200924). Median PFS was significantly longer with S\u2010IROX than with NFF (6.29 vs. 3.45\u2009months;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.048), and the overall response rate was higher (29% vs. 9%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.038). Median OS did not differ significantly (12.81 vs. 10.64\u2009months;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.170). The incidence of grade \u2265\u20093 adverse events was comparable. Multivariate analysis identified S\u2010IROX, modified Glasgow Prognostic Score (mGPS) 0, and CA19\u20109\u2009&lt;\u2009373\u2009IU\/L as independent predictors of longer PFS, while mGPS 0 and CA19\u20109\u2009&lt;\u2009373\u2009IU\/L were associated with longer OS. Subgroup analyses showed favorable outcomes with S\u2010IROX in locally advanced disease.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>S\u2010IROX may be an effective and safe second\u2010line option after GnP, particularly for locally advanced PC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jhbp.70122","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T10:11:44Z","timestamp":1777457504000},"page":"701-711","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of Nanoliposomal Irinotecan Plus Fluorouracil\/Leucovorin and S\u20101, Irinotecan, and Oxaliplatin as Second\u2010Line Chemotherapy After Gemcitabine Plus Nab\u2010Paclitaxel for Unresectable Pancreatic Cancer"],"prefix":"10.1002","volume":"33","author":[{"given":"Masahiro","family":"Itonaga","sequence":"first","affiliation":[{"name":"Second Department of Internal Medicine Wakayama Medical University  Wakayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reiko","family":"Ashida","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine Wakayama Medical University  Wakayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5611-2509","authenticated-orcid":false,"given":"Takashi","family":"Tamura","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine Wakayama Medical University  Wakayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6725-5708","authenticated-orcid":false,"given":"Yasunobu","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine Wakayama Medical University  Wakayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Kawaji","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine Wakayama Medical University  Wakayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Shishimoto","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine Wakayama Medical University  Wakayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromu","family":"Morishita","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine Wakayama Medical University  Wakayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisuke","family":"Hanada","sequence":"additional","affiliation":[{"name":"Clinical Study Support Center Wakayama Medical University  Wakayama 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