In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 38, No. 4_suppl ( 2020-02-01), p. 649-649
Abstract:
649 Background: Patients with metastatic pancreatic cancer refractory to first-line chemotherapy (CTx) have limited treatment options. Moreover, it is unclear what kind of patients could be brought about survival benefit by 2nd-line CTx after refractory to gemcitabine+ nab-PTX (GnP) or FOLFIRINOX. Methods: This analysis was performed as part of a multicenter retrospective study of GnP or FOLFIRINOX in patients with unresectable pancreatic cancer (NAPOLEON study) conducted by 14 centers in Japan. From December 2013 to March 2017, 255 patients with advanced or recurrent pancreatic cancer received GnP or FOLFIRINOX as 1st-line CTx. Excluding censored cases in first-line treatment, 156 and 77 patientsreceived 2nd-line CTx and best supportive care (BSC), respectively. Variables at the refractory or intolerant to the 1st-line treatment were used to investigate correlation with prognosis by Cox regression model. Then, we made scoring system using the prognostic factors to reveal the benefit of 2nd-line CTx. Results: Median post-progression survivals (PPSs) were 5.2 months in 2nd-line CTx group and 2.7 months in BSC group, respectively (hazard ratio [HR] ; 0.42, 95% confidence interval [CI]; 0.31-0.57, p 〈 0.01). According to the Cox regression model, serum Alb level of less than 3.5 g/dL (HR; 1.98, 95% CI; 1.33–2.96, p 〈 0.01) and CA19-9 level of greater than 1,000 U/mL (HR; 1.87, 95% CI; 1.25–2.80, p 〈 0.01) were independent predictive factors. The scoring system for PPS was designed using these factors, which was obtained by summing up serum Alb (≥ and 〈 3.5 g/dL allocated to scores 0 and 1) and CA19-9 ( 〈 and ≥ 1,000 U/mL allocated to scores 0 and 1) at disease progression in patients with 2nd-line CTx group. Patients with score 0 and 1 displayed significantly favorable PPSs in comparison with BSC group; however, there was no significant difference in PPS between patients with score 2 and BSC group (Table). Conclusions: Survival benefit of 2nd-line CTx was observed in patients with the score 0 and 1, but not in the score 2. [Table: see text]
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/JCO.2020.38.4_suppl.649
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2020
detail.hit.zdb_id:
2005181-5
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