{"doi":"10.1002/cnr2.1565","title":"Cost‐effectiveness of neoadjuvant <scp>FOLFIRINOX</scp> versus gemcitabine plus nab‐paclitaxel in borderline resectable/locally advanced pancreatic cancer patients","abstract":"BACKGROUND: The 2020 National Comprehensive Cancer Network guidelines recommend neoadjuvant FOLFIRINOX or neoadjuvant gemcitabine plus nab-paclitaxel (G-nP) for borderline resectable/locally advanced pancreatic ductal adenocarcinoma (BR/LA PDAC). AIM: The purpose of our study was to compare treatment outcomes, toxicity profiles, costs, and quality-of-life measures between these two treatments to further inform clinical decision-making. METHODS AND RESULTS: We developed a decision-analytic mathematical model to compare the total cost and health outcomes of neoadjuvant FOLFIRINOX against G-nP over 12 years. The model inputs were estimated using clinical trial data and published literature. The primary endpoint was incremental cost-effectiveness ratios (ICERs) with a willingness-to-pay threshold of $100 000 per quality-adjusted-life-year (QALY). Secondary endpoints included overall (OS) and progression-free survival (PFS), total cost of care, QALYs, PDAC resection rate, and monthly treatment-related adverse events (TRAE) costs (USD). FOLFIRINOX was the cost-effective strategy, with an ICER of $60856.47 per QALY when compared to G-nP. G-nP had an ICER of $44639.71 per QALY when compared to natural history. For clinical outcomes, more patients underwent an \"R0\" resection with FOLFIRINOX compared to G-nP (84.9 vs. 81.0%), but FOLFIRINOX had higher TRAE costs than G-nP ($10905.19 vs. $4894.11). A one-way sensitivity analysis found that the ICER of FOLFIRINOX exceeded the threshold when TRAE costs were higher or PDAC recurrence rates were lower. CONCLUSION: Our modeling analysis suggests that FOLFIRNOX is the cost-effective treatment compared to G-nP for BR/LA PDAC despite having a higher cost of total care due to TRAE costs. Trial data with sufficient follow-up are needed to confirm our findings.","journal":"Cancer Reports","year":2022,"id":283146,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":6,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9541,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":581604,"name":"Brianna N. Lauren","orcid":"0000-0003-3608-6777","position":1,"is_corresponding":false},{"id":581605,"name":"Yoanna S Pumpalova","orcid":"0000-0001-5520-9264","position":2,"is_corresponding":false},{"id":827015,"name":"Jiheum Park","orcid":"0000-0003-4919-7249","position":3,"is_corresponding":false},{"id":18379,"name":"Francesca Lim","orcid":"0000-0001-7194-2845","position":4,"is_corresponding":false},{"id":3641,"name":"Susan E. Bates","orcid":"0000-0001-6708-0330","position":5,"is_corresponding":false},{"id":53984,"name":"Fay Kastrinos","orcid":"0000-0003-2518-0100","position":6,"is_corresponding":false},{"id":322445,"name":"Gulam A. Manji","orcid":"0000-0001-9817-2414","position":7,"is_corresponding":false},{"id":218027,"name":"Chung Yin Kong","orcid":"0000-0001-6431-7830","position":8,"is_corresponding":false},{"id":474717,"name":"Chin Hur","orcid":"0000-0002-2819-7576","position":9,"is_corresponding":false},{"id":474715,"name":"Myles Ingram","orcid":"0000-0001-9703-5805","position":0,"is_corresponding":true}],"reference_count":43,"raw_metadata":null,"created_at":"2026-07-19T00:29:23.777809Z","pmid":"35122419","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}