Pancreatic Cancer · Medical Oncology
PRODIGE 24/PA6
After pancreatic cancer resection, does adjuvant modified FOLFIRINOX improve survival compared with gemcitabine?
Population
493 patients with resected pancreatic ductal adenocarcinoma
5-year OS
43.2% vs 31.4%
Absolute improvement 11.8 points; NNT 9
Median OS
53.5 vs 35.5 months
HR 0.68
Grade 3–4 adverse events
75.9% vs 51.9%
Absolute increase 24 points; NNH 5
Absolute Effect
NNT: 9, based on 5-year overall survival. The absolute survival improvement was 11.8 percentage points.
NNH: 5, based on grade 3–4 adverse events. Severe toxicity was substantially more common with mFOLFIRINOX.
Clinical interpretation
PRODIGE 24 demonstrates one of the clearest benefit–burden trade-offs in adjuvant pancreatic cancer: a meaningful long-term survival gain accompanied by a very large increase in severe toxicity. Patient fitness and tolerance are therefore central to treatment selection.
Primary source
Conroy T, et al. Long-term PRODIGE 24/PA6 analysis. JAMA Oncol. 2022.