Multicenter phase 2-3 study of first-line S-1 plus irinotecan and oxaliplatin versus mFOLFIRINOX or paclitaxel-gemcitabine for metastatic pancreatic cancer

The phase 2-3 GENERATE trial , at 45 centers in Japan, compared mFOLFIRINOX, S1 plus irinotecan and oxaliplatin (S-IROX), and nab-paclitaxel plus gemcitabine as first-line treatment for metastatic or recurrent pancreatic cancer. Primary endpoint was overall survival. The trial found no significant OS differences between the three arms. Grade 3 or 4 anorexia was more frequent with mFOLFIRINOX (23.3%) and S-IROX (27.5%) than with nab-paclitaxel plus gemcitabine (5%). The author conclude that neither mFOLFIRINOX nor S-IROX appeared to be superior compared with nab-paclitaxel plus gemcitabine as first-line treatment for metastatic or recurrent pancreatic cancer.