A small retrospective study suggests that nanoliposomal irinotecan (nal-IRI) plus 5-fluorouracil (5-FU) and l-leucovorin (LV) may be an effective second- or later-line treatment for rare non-ductal pancreatic cancers after gemcitabine-based therapy fails.
The study included nine patients with rare tumor subtypes, including acinar cell, adenosquamous, undifferentiated, and neuroendocrine carcinomas. The combination achieved an objective response rate of 44.4% and a disease control rate of 77.8%. Median progression-free survival was 6.8 months, while median overall survival had not yet been reached. Several patients maintained tumor control for more than 10 to 17 months.
The treatment was generally well tolerated, with the most common severe side effects involving low blood cell counts. Although limited by its small size, the findings provide early evidence that nal-IRI plus 5-FU/LV could offer a promising treatment option for patients with rare pancreatic cancer subtypes who have few established therapies after first-line treatment fails.