Simple prognostic markers for optimal treatment of patients with unresectable pancreatic cancer

Introduction: Patients with advanced pancreatic cancer have a poor prognosis. FOLFIRINOX (FFX) and gemcitabine plus nab-paclitaxel (GnP) have been established as first-line treatment, but they have not been confirmed as second-line treatment after FFX. The aim of this study was to evaluate the safety and efficacy of GnP as second-line therapy after FFX in patients with unresectable pancreatic cancer. Methods: Twenty-five patients with unresectable pancreatic cancer were enrolled. The patients were treated with GnP after FFX between September 2015 and September 2019. Tumor response, progression-free survival (PFS), overall survival (OS), and incidence of adverse events were evaluated. Results: The response rate, disease control rate, median PFS, and median OS were 12%, 96%, 5.3 months, and 15.6 months, respectively. The common grade 3 or 4 adverse events were neutropenia (76%) and anemia (16%). Conclusions: GnP after FOLFIRINOX is expected to be one of the second-line recommendations for patients with unresectable pancreatic cancer.

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Choledochoduodenostomy for Palliation in Unresectable Pancreatic Cancer

Archives of Surgery ◽

10.1001/archsurg.133.8.820 ◽

1998 ◽

Vol 133 (8) ◽

pp. 820 ◽

Cited By ~ 15

Author(s):

L. Andrew DiFronzo

Keyword(s):

Pancreatic Cancer ◽

Unresectable Pancreatic Cancer

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Palliative care consultation and aggressive care at end of life in unresectable pancreatic cancer

Current Oncology ◽

10.3747/co.26.4389 ◽

2019 ◽

Vol 26 (1) ◽

Cited By ~ 1

Author(s):

C. Lees ◽

S. Weerasinghe ◽

N. Lamond ◽

T. Younis ◽

Ravi Ramjeesingh

Keyword(s):

Pancreatic Cancer ◽

Palliative Care ◽

End Of Life ◽

Potential Effect ◽

Unresectable Pancreatic Cancer ◽

Palliative Care Consultation ◽

Integral Role ◽

Care Consultation ◽

Aggressive Care ◽

Key Indicators

Background Palliative care (pc) consultation has been associated with less aggressive care at end of life in a number of malignancies, but the effect of the consultation timing has not yet been fully characterized. For patients with unresectable pancreatic cancer (upcc), aggressive and resource-intensive treatment at the end of life can be costly, but not necessarily of better quality. In the present study, we investigated the association, if any, between the timing of specialist pc consultation and indicators of aggressive care at end of life in patients with upcc.Methods This retrospective cohort study examined the potential effect of the timing of specialist pc consultation on key indicators of aggressive care at end of life in all patients diagnosed with upcc in Nova Scotia between 1 January 2010 and 31 December 2015. Statistical analysis included univariable and multivariable logistic regression.Results In the 365 patients identified for inclusion in the study, specialist pc consultation was found to be associated with decreased odds of experiencing an indicator of aggressive care at end of life; however, the timing of the consultation was not significant. Residency in an urban area was associated with decreased odds of experiencing an indicator of aggressive care at end of life. We observed no association between experiencing an indicator of aggressive care at end of life and consultation with medical oncology or radiation oncology.Conclusions Regardless of timing, specialist pc consultation was associated with decreased odds of experiencing an indicator of aggressive care at end of life. That finding provides further evidence to support the integral role of pc in managing patients with a life-limiting malignancy.

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