{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T14:32:12Z","timestamp":1760711532527,"version":"3.40.5"},"reference-count":27,"publisher":"Korean Cancer Association","issue":"2","license":[{"start":{"date-parts":[[2024,10,17]],"date-time":"2024-10-17T00:00:00Z","timestamp":1729123200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"funder":[{"DOI":"10.13039\/501100005006","name":"Asan Institute for Life Sciences, Asan Medical Center","doi-asserted-by":"publisher","award":["2020IL0018"],"award-info":[{"award-number":["2020IL0018"]}],"id":[{"id":"10.13039\/501100005006","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["e-crt.org"],"crossmark-restriction":true},"short-container-title":["Cancer Res Treat"],"published-print":{"date-parts":[[2025,4,15]]},"abstract":"<jats:p>PurposeWhile fluoropyrimidine-based chemotherapy regimens are recommended second-line treatment for patients with advanced biliary tract cancer (BTC), there have been no studies comparing different regimens head-to-head.Materials and Methods We performed individual patient-level meta-analysis based on data from the intention-to-treat population of the phase 2b NIFTY trial (liposomal irinotecan [nal-IRI] plus fluorouracil and leucovorin [5-FU\/LV] vs. 5-FU\/LV; NCT03542508) and the phase 2 FIReFOX trial (modified oxaliplatin plus 5-FU\/LV [mFOLFOX] vs. modified irinotecan plus 5-FU\/LV [mFOLFIRI]; NCT03464968). Pairwise log-rank tests and multivariable analysis using Cox proportional hazards modeling with shared frailty to account for the trial's effect were used to compare overall survival (OS) between regimens. Results A total of 277 patients were included. The nal-IRI plus 5-FU\/LV group (n=88) showed significantly better OS compared to the mFOLFOX group (n=49, pairwise log-rank, p=0.02), and mFOLFIRI group (n=50, p=0.03). Multivariable analysis showed consistent trends in OS with adjusted hazard ratios of 1.39 (mFOLFOX vs. nal-IRI plus 5-FU\/LV: 95% confidence interval [CI], 0.93 to 2.07; p=0.11) and 1.36 (mFOLFIRI vs. nal-IRI plus 5-FU\/LV: 95% CI, 0.92 to 2.03; p=0.13), respectively. Compared to the 5-FU\/LV group, the mFOLFOX group and the mFOLFIRI group did not show differences in terms of OS (pairwise log-rank p=0.83 and p=0.58, respectively). The nal-IRI plus 5-FU\/LV group experienced more frequent diarrhea, while the mFOLFOX group experienced peripheral neuropathy.Conclusion Nal-IRI plus 5-FU\/LV showed favorable survival outcomes compared to mFOLFOX, mFOLFIRI, or 5-FU\/LV. The safety profiles of these regimens should be considered along with efficacy.<\/jats:p>","DOI":"10.4143\/crt.2024.652","type":"journal-article","created":{"date-parts":[[2024,10,17]],"date-time":"2024-10-17T03:01:47Z","timestamp":1729134107000},"page":"519-527","update-policy":"https:\/\/doi.org\/10.4143\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Second-Line Fluoropyrimidine-Based Chemotherapy in Advanced Biliary Tract Cancer: A Meta-analysis Based on Individual Patient-Level Data of Randomized 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