OBJECTIVES: In 2020, there were 495,773 new cases of pancreatic cancer worldwide, ranking 14th in the world’s most common cancer incidence. This article aims to review and evaluate the literature review and evaluation of the safety, effectiveness and economics of irinotecan liposome combined with 5-FU/LV regimen and other second-line treatment regimens in patients with metastatic pancreatic cancer who have previously received gemcitabine treatment.

METHODS: Searches were performed until February 2021 mainly using electronic databases for PubMed, ClinicalTrials, Cochrane library ,etc. Collect the relevant literature of the use of irinotecan liposomes combined with 5-FU/LV and 5-FU/LV, oxaliplatin combined with 5-FU/LV and other programs for patients with metastatic pancreatic cancer who have previously received gemcitabine treatment. The main outputs are mOS, mPFS, serious adverse events, grade 3-4 adverse events and QALYs, ICER, etc. The inclusion criteria include randomized controlled trials, systematic literature reviews, meta-analysis, etc.

RESULTS: According to the inclusion and exclusion criteria, 19 articles were finally included, including 12 safety and effectiveness evaluations, involving NAPOLI-1, a global trial with 417 patients.The randomized controlled trials have a very high randomization grouping method, the result is complete, but the results are not selectively reported, they are at high risk in terms of allocation methods, blinding, and other biases.

CONCLUSIONS: According to the results of the NAPOLI-1 test, it can be found that irinotecan liposome combined with 5-FU/LV has a higher clinical benefit than 5-FU/LV, but there is currently a lack of comparison of economic evaluation between irinotecan liposomes combined with 5-FU/LV and 5-FU/LV regimens. At the same time, there is a lack of evidence for safe and effective comparison and corresponding economic evaluation between irinotecan liposome combined treatment regimen and oxaliplatin combined 5-FU/LV regimen.