Second-line chemotherapy after gemcitabine plus nab-paclitaxel in metastatic pancreatic cancer: comparative outcomes and AI-guided treatment selection - PubMed
6 hours ago
- #second-line chemotherapy
- #pancreatic cancer
- #interpretable artificial intelligence
- Second-line chemotherapy options for metastatic pancreatic cancer after gemcitabine plus nab-paclitaxel failure include 5FU/LV, Nal-IRI + 5FU/LV, FOLFIRI, FOLFOX, or FOLFIRINOX.
- FOLFIRINOX showed the longest progression-free survival (PFS) and overall survival (OS) among the treatments.
- Nal-IRI + 5FU/LV demonstrated long-term benefits for patients with head/body tumors, ECOG PS 0, or CA19.9 < 109 U/mL in those with PS > 0.
- Interpretable artificial intelligence (IAI) methods, including an Optimal Policy Tree (OPT), were used to guide treatment selection, showing superior net clinical benefit over uniform approaches.
- The study suggests integrating IAI-derived treatment policies with upcoming targeted strategies like RAS inhibitors for personalized therapy.