NALIRIFOX versus nab-paclitaxel and gemcitabine in older patients with treatment-naive metastatic pancreatic cancer: a subgroup analysis of the pivotal NAPOLI 3 trial

ESMO Open 2026 Open access

Read full text
Authors: T. Macarulla, R.Pazo Cid, M.S. Womack, A. Cubillo Gracian, A. Zervoudakis, H. Hatoum, V. Chung, A. Patel, A.S. Paulson, S. Pant, EM O’Reilly, R. Hubner
+8 more E. Van Cutsem, T. Bekaii-Saab, L. Zhang, J. -Y. Li, H. Chen, F. Maxwell, Z.A. Wainberg, D. Melisi
DOI: 10.1016/j.esmoop.2025.106043
Cited by: 2
References: 22

Abstract

BACKGROUND: The phase III NAPOLI 3 trial established liposomal irinotecan in combination with 5-fluorouracil/leucovorin plus oxaliplatin (NALIRIFOX) as a superior first-line (1L) treatment option compared with gemcitabine plus nab-paclitaxel (Gem + NabP) in patients with previously untreated metastatic pancreatic ductal adenocarcinoma (mPDAC), without imposing an upper age limit on enrollment. The current analysis of the NAPOLI 3 data investigated the potential impact of older age on the efficacy and safety of NALIRIFOX. PATIENTS AND METHODS: Adults with previously untreated mPDAC were randomly assigned in a 1 : 1 ratio to receive NALIRIFOX or Gem + NabP. This post hoc analysis compared outcomes for patients aged ≥70 years versus

Fields of Study & Subjects

Pancreatic and Hepatic Oncology Research Peptidase Inhibition and Analysis Renal cell carcinoma treatment

Publication details

Journal / source
ESMO Open
Publisher
Elsevier BV
Volume
11
Issue
3
Pages
106043–106043
Publication date
12 February 2026
Language
EN