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Reply to ‘NALIRIFOX in the frontline for metastatic pancreatic cancer: evidence beyond NAPOLI 3’

Nature Reviews Clinical Oncology volume 21, page 902 (2024)Cite this article

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We appreciate the interest of Wainberg and O’Reilly in our recently published News & Views article that critiques the design and reporting of results from the NAPOLI 3 trial (Nevala-Plagemann, C. & Garrido-Laguna, I. NALIRIFOX for metastatic pancreatic adenocarcinoma: hope or hype? Nat. Rev. Clin. Oncol. 21, 567–568 (2024))1. In their Correspondence (Wainberg, Z. A. & O’Reilly, E. M. NALIRIFOX in the frontline for metastatic pancreatic cancer: evidence beyond NAPOLI 3. Nat. Rev. Clin. Oncol. https://doi.org/10.1038/s41571-024-00952-5 (2024))2, they raise several points that we would like to address.

We do not dispute the statement that cross-trial comparisons are fraught with bias; however, we want to point out that, despite their claims of our comparison of NAPOLI 3 and PRODIGE 4 being scientifically invalid, in the discussion section of the NAPOLI 3 manuscript the authors themselves perform a direct cross-trial comparison of these same trials when highlighting the outcomes of patients receiving NALIRIFOX, by stating: “The median progression-free survival was 7.4 months … and the overall response rate per investigator was 41.8% for NALIRIFOX in NAPOLI 3, and 6.4 … months and 31.6%, respectively, for FOLFIRINOX in PRODIGE”3.

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References

  1. Nevala-Plagemann, C. & Garrido-Laguna, I. NALIRIFOX for metastatic pancreatic adenocarcinoma: hope or hype? Nat. Rev. Clin. Oncol. 21, 567–568 (2024).

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  2. Wainberg, Z. A. & O’Reilly, E. M. NALIRIFOX in the frontline for metastatic pancreatic cancer: evidence beyond NAPOLI 3. Nat. Rev. Clin. Oncol. https://doi.org/10.1038/s41571-024-00952-5 (2024).

  3. Wainberg, Z. A. et al. NALIRIFOX versus nab-paclitaxel and gemcitabine in treatment-naive patients with metastatic pancreatic ductal adenocarcinoma (NAPOLI 3): a randomised, open-label, phase 3 trial. Lancet 402, 1272–1281 (2023).

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Authors and Affiliations

  1. Division of Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA

    Christopher Nevala-Plagemann & Ignacio Garrido-Laguna

  2. Department of Medical Oncology, Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France

    Thierry Conroy

  3. Inserm INSPIIRE, Université de Lorraine, Nancy, France

    Thierry Conroy

Authors
  1. Christopher Nevala-Plagemann
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  2. Thierry Conroy
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  3. Ignacio Garrido-Laguna
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Corresponding author

Correspondence to Ignacio Garrido-Laguna.

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Competing interests

C.N.-P. receives institutional research funding from Theriva and has had an advisory role at Seagen. I.G.-L. receives institutional research funding from Revolution Medicine, Quanta Therapeutics, 280 Bio, Bayer, BridgeBio Pharma, Bristol–Myers Squibb, GlaxoSmithKline, Incyte, Jacobio, Lilly, MedImmune, Novartis, Pfizer, Repare Therapeutics, Sumitomo Dainippon Pharma Oncology and Tolero Pharmaceuticals; has had consulting or advisory roles at Jazz, Kanaph, Lilly, OncXerna Therapeutics and SOTIO; and an uncompensated consulting role for Revolution Medicine. T.C. declares no competing interests.

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Nevala-Plagemann, C., Conroy, T. & Garrido-Laguna, I. Reply to ‘NALIRIFOX in the frontline for metastatic pancreatic cancer: evidence beyond NAPOLI 3’. Nat Rev Clin Oncol 21, 902 (2024). https://doi.org/10.1038/s41571-024-00953-4

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