The efficacy of first-line chemotherapy in recurrent pancreatic cancer after S-1 adjuvant chemotherapy.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 475-475
Author(s):  
Ryo Kanata ◽  
Masato Ozaka ◽  
Seita Kataoka ◽  
Kazunaga Ishigaki ◽  
Ikuhiro Yamada ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Adjuvant Chemotherapy ◽  
Cox Regression ◽  
Surrogate Marker ◽  
Cancer Recurrence ◽  
Progression Free Survival ◽  
Free Survival ◽  
Cox Regression Analysis ◽  
Recurrent Pancreatic Cancer ◽  
Line Chemotherapy

475 Background: In Japan, adjuvant chemotherapy with S-1 for 6 months is standard care for resected pancreatic cancer. However, the efficacy of chemotherapy for recurrent pancreatic cancer(RPC) after adjuvant S-1 chemotherapy is not well evaluated. Methods: Medical records were retrospectively reviewed for consecutive patients who had RPC after adjuvant S-1 treatment and received chemotherapy between April 2013 and July 2016. Recurrence free interval (RFI) was defined as the interval from adjuvant S-1 initiation to cancer recurrence. Overall survival (OS) and progression free survival (PFS) after 1st line chemotherapy for RPC were compared between patients with RFIs of shorter than 6 month (Group S) and longer than 6 months (Group L). Results: In the 53 patients evaluated, the median duration of adjuvant S-1 chemotherapy was 5.1 months, and the median RFI was 8.3 months. After recurrence, they received Gemcitabine alone (20 patients), Gemcitabine+nab-paclitaxel (28 patients), modified FOLFIRINOX (one patient), and other regimen (4 patients). In all patients, the median PFS was 7.3 months and the median OS was 14.8 months. When compered in two groups (group S and group L), median OS in group S and group L was 6.7 months (95% confidence interval(CI): 4.2-12.9) and NA (95% CI: 13 months-NA) , respectively (p < 0.001), and median PFS was 3.8 months (95%CI: 2.5-9.1) and 7.3 months (95%CI: 3.9-15.3), respectively (p = 0.11). Multivariate Cox regression analysis revealed CEA < 4.0 mg/dl before chemotherapy and an RFI of ≥ 6 months were significantly associated with longer survival. Conclusions: These data suggest that RFI < 6 months is a surrogate marker for a poor prognosis in patients with RPC.

Efficacy of chemotherapy in patients with recurrent pancreatic cancer.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 466-466 ◽  
Author(s):  
Akihiro Ohba ◽  
Hideki Ueno ◽  
Yuji Inagaki ◽  
Yasunari Sakamoto ◽  
Shunsuke Kondo ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Adjuvant Chemotherapy ◽  
Liver Metastases ◽  
Performance Status ◽  
Progression Free Survival ◽  
Similar Efficacy ◽  
Lower Percentage ◽  
First Line ◽  
Recurrent Pancreatic Cancer ◽  
Line Chemotherapy

466 Background: Gemcitabine (GEM) plus nab-paclitaxel (GnP) and FOLFIRINOX (FFX) are standard first-line chemotherapy regimens for metastatic pancreatic cancer (MPC) patients. GEM and S-1 are also used for these patients in Japan. However, the phase 3 trials included a small proportion of recurrent pancreatic cancer (RPC) patients, and patients who had received adjuvant chemotherapy were excluded. In clinical practice, RPC is treated in the same way as MPC. The aim of this study is to compare the efficacy of chemotherapy between RPC and MPC. Methods: We retrospectively analyzed the patients with RPC or MPC who received GnP, FFX, GEM, or S-1 as first-line chemotherapy between January 2014 and March 2016 in our institution. RPC was defined as pancreatic cancer with recurrence after R0 or R1 resection. Overall survival (OS), progression-free survival (PFS), response rate (RR), and disease control rate (DCR) were evaluated. Multivariate analyses of OS were performed with the use of a Cox proportional-hazard model. Results: A total of 181 patients, 40 RPC and 141 MPC, were selected in this study. RPC and MPC groups were similar with respect to age, sex, and performance status (PS). However, the RPC group had lower percentage of liver metastases (P < 0.001). The regimens were GnP/FFX/GEM/S-1: 10/3/20/7 in the RPC group and 37/34/67/3 in the MPC group, respectively. In the RPC group, 31 of 40 patients had received adjuvant chemotherapy; S-1/GEM: 24/7. The median OS was 16.6 months in the RPC group as compared with 9.7 months in the MPC group (hazard ratio [HR] 0.64, 95% confidence interval [CI] 0.37–1.10, P = 0.11). The median PFS was 4.8 months in the RPC group and 4.4 months in the MPC group (HR 0.86, 95% CI 0.57–1.30, P = 0.47). The RR was 10% versus 14% (P = 0.79), the DCR was 50% versus 52% (P = 0.86), in the two groups, respectively. Multivariate analysis showed PS (HR 2.19, 95% CI 1.38–3.49) and liver metastases (HR 2.34, 95% CI 1.47–2.34) were independent predictors of OS. On the other hand, RPC or MPC was not found to be an independent prognostic factor (HR 1.19, 95% CI 0.67–2.13). Conclusions: It is suggested that chemotherapy in RPC may have similar efficacy compared to MPC. The relatively longer OS in the RPC group seems to associate with the lower percentage of liver metastases.

Association between prior radical surgery (RS) and outcomes with immune checkpoint inhibitor (ICI) therapy for advanced urothelial carcinoma (aUC).

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 444-444
Author(s):  
Dimitrios Makrakis ◽  
Daniel Castellano ◽  
Ivan de Kouchkovsky ◽  
Joseph J. Park ◽  
Mehmet Asim Bilen ◽  
...  
Keyword(s):  
Immune Checkpoint Inhibitor ◽  
Overall Response Rate ◽  
Cox Regression ◽  
Progression Free Survival ◽  
Similar Proportion ◽  
Multivariable Model ◽  
Free Survival ◽  
Cox Regression Analysis ◽  
Response Table ◽  
Advanced Urothelial Carcinoma

444 Background: It is unclear whether prior RS of primary tumor is associated with response and outcomes with ICI in aUC. We hypothesized that such response and outcomes would not differ based on prior RS. Methods: We performed a retrospective cohort study including patients (pts) with aUC who received ICI. We compared overall response rate (ORR), progression-free survival (PFS), and overall survival (OS) between pts with vs without RS [cystectomy or (nephro)-ureterectomy]. Analysis was stratified based on ICI therapy line (first-line vs salvage). A separate comparison between pts with prior RS or radiation (RT) only or none was also pursued. ORR was compared between groups using logistic regression, as well OS and PFS using cox regression analysis; a multivariable model was built adjusting for calculated Bellmunt score. P<0.05 was significant. Results: We identified 984 pts from 24 institutions; 682, 704 and 673 were included in OS, PFS and ORR analyses, respectively; 54% of pts had prior RS with median age 68 at ICI initiation with RS vs 71 without RS with similar proportion of men (73-74%) and ever smokers (70-71%). The RS group had higher proportion (%) of white pts (77% vs 71%), lower % of pts with Hb<10g/dL at ICI initiation (23% vs 32%) but not significantly higher % of liver metastasis at ICI initiation (23% vs 17%). Bellmunt score with vs without RS was 16% vs 11%, 50% vs 48%, 27% vs 37%, 7% vs 4% for 0, 1, 2, and 3, respectively. ORR and PFS were not significantly different between groups, while prior RS was associated with longer OS (unadjusted HR 0.8, p=0.03). However, after adjustment for Bellmunt score, this association was not significant (table). Upon stratification based on treatment line, OS was longer with prior RS (0.7, p=0.03) for those treated with salvage ICI but this was not significant after adjusting for Bellmunt score. ORR, PFS and OS were not significantly different between pts receiving prior RT only vs RS vs none. Conclusions: Prior RS was not significantly associated with longer OS in pts with aUC receiving ICI after adjusting for Bellmunt score. Further work is needed to interrogate tumor-host immune interactions and identify biomarkers that can be prognostic and/or predictive of ICI response. [Table: see text]

scholarly journals Identification and validation of AKR1C1/2/3 as hepatocellular carcinoma risk modules via an integrated strategy

2020 ◽  
Author(s):  
Mingxing Xu ◽  
Yuesi Zhong ◽  
Fangji Yang ◽  
Kai Liu ◽  
Baoding Zhuang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Cox Regression ◽  
Significant Risk ◽  
Reduction Process ◽  
Progression Free Survival ◽  
Tumor Stage ◽  
Genetic Alterations ◽  
Metabolic Process ◽  
Free Survival ◽  
Cox Regression Analysis

Abstract Background The human aldo-keto reductase 1 (AKR1) C family comprises four enzymes, AKR1C1–AKR1C4. Lots of studies have investigated the function of AKR1Cs in tumors, however little is known in hepatocellular carcinoma (HCC). Methods Public databases were used to explore expression and role of AKR1Cs in HCC. Meanwhile, data of 134 HCC patients from Firebrowse website was used for validation. Results The results revealed that AKR1Cs expression was negatively correlated with the infiltration level of CD4+ T cells. Overexpression of AKR1C1/2/3 was significantly associated with tumor stage and pathological grade. Moreover, higher mRNA expression of AKR1C1/2/3 was related with shorter overall survival (OS), progression-free survival (PFS) and relapse-free survival (RFS). Multivariate Cox regression analysis showed that AKR1C1/2/3 could be significant risk factors for HCC patients. Additionally, genetic alterations of AKR1Cs can significantly affect patient OS and PFS, and expression of AKR1Cs was linked to functional networks involving oxidation-reduction process, cellular hormone metabolic process and organic hydroxy compound metabolic process, as well as retinol metabolism, steroid hormone biosynthesis, metabolic pathway and fatty acid degradation pathways. Conclusions In conclusion, we successfully elaborated the relationship between AKR1Cs expression and immune infiltrations, and identified AKR1C1/2/3 could be novel prognostic biomarkers for HCC patients.

scholarly journals Distant Survival for Patients Undergoing Surgery Using Volatile versus IV Anesthesia for Hepatocellular Carcinoma with Portal Vein Tumor Thrombus:A Retrospective study.

2020 ◽  
Author(s):  
Xiao-Yan Meng ◽  
Xiu-Ping Zhang ◽  
Hong-Qian Wang ◽  
Weifeng Yu
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Portal Vein ◽  
Cox Regression ◽  
Cancer Recurrence ◽  
Survival Outcomes ◽  
Free Survival ◽  
Cox Regression Analysis ◽  
Underlying Causes ◽  
The Impact

Abstract Background Whether anesthesia type is associate with the surgical outcome of Hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT) remains to be determined. This study aims to investigate the impact of volatile inhalational anesthesia (INHA) versus total IV anesthesia (TIVA) on the survival outcomes in HCC patients with PVTT. Methods A cohort of in-patients whom were diagnosed of HCC with PVTT in Eastern Hepatobiliary Surgery Hospital, Shanghai, China, from January 1, 2008 to December 24, 2012 were identified. Surgical patients receiving the INHA and TIVA were screened out. The overall survival (OS), recurrence-free survival (RFS) and several postoperative adverse events were compared according to anesthesia types. Results A total of 1513 patients were included in this study. After exclusions are applied, 263 patients remain in the INHA group and 208 in the TIVA group. Patients receiving INHA have a lower 5-year overall survival rate than that of patients receiving TIVA [12.6% (95% CI, 9.0 to 17.3) vs. 17.7% (95% CI, 11.3 to 20.8), P=0.024]. Results of multivariable Cox-regression analysis also identify that INHA anesthesia is significantly associated with mortality and cancer recurrence after surgery compare to TIVA, with HR (95%CI) of 1.303 (1.065, 1.595) and 1.265 (1.040, 1.539), respectively. Subgroup analysis suggested that in more severe cancer patients, the worse outcome related to INHA might be more significant. Conclusion This retrospective analysis identifies that TIVA has better survival outcomes compare to INHA in HCC patients with PVTT. Future prospective researches are urgent to verify this difference and figure out underlying causes of it.

Gastric juice piR-1245: A promising prognostic biomarker for gastric cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16574-e16574
Author(s):  
Wei Peng ◽  
Jianhong Liu ◽  
Xiaorong Zhou ◽  
Hong Fan ◽  
Jianwei Lu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Gastric Juice ◽  
Cox Regression ◽  
Progression Free Survival ◽  
Healthy Individuals ◽  
Free Survival ◽  
Cox Regression Analysis ◽  
Diagnosis And Prognosis ◽  
Potential Marker ◽  
Risk Variable

e16574 Background: Emerging reports demonstrated that PIWI-interacting RNAs (piRNAs) played an indispensable role in tumorigenesis. However, it still remains elusive whether piR-1245 in gastric juice specific in stomach could be employed as a biomarker for gastric cancer (GC). The present work is aiming at exploring the possibility of piR-1245 in gastric juice as a potential marker to judge for diagnosis and prognosis of gastric cancer. Methods: Gastric juice was collected from 66 GC patients and 66 healthy individuals. Quantitative real-time reverse transcriptase polymerase chain reaction (qRT-PCR) was employed to measure the levels of piR-1245 expression. Then, the pattern of piR-1245 expression in gastric juice was determined between GC patients and healthy individuals. A receiver operating characteristic (ROC) curve was constructed for distinguishing GC from healthy individuals. Results: Gastric juice piR-1245 levels in GC were higher than those of controls (P < 0.0001). The value of area under ROC (AUC) was 0.885 (sensitivity, 90.9%; specificity, 74.2%; 95% confidence interval, 0.8286 to 0.9414). High gastric juice piR-1245 expression was signally correlated with tumor size (P = 0.013) and TNM stage (P = 0.001). GC patients with high piR-1245 expression in gastric juice exerted a poorer overall survival (OS) (P = 0.0152) and progression-free survival (PFS) (P = 0.013). COX regression analysis verified that gastric juice piR-1245 expression was an independent prognostic risk variable for OS (P < 0.05). Conclusions: The current study suggested that piR-1245 in gastric juice had the potential to be a useful biomarker for GC detection and prognosis prediction.

scholarly journals Excision Repair Cross-Complementation Group 6 Gene Polymorphism Is Associated with the Response to FOLFIRINOX Chemotherapy in Asian Patients with Pancreatic Cancer

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1196
Author(s):  
Young Hoon Choi ◽  
Younggyun Lim ◽  
Ji Kon Ryu ◽  
Woo Hyun Paik ◽  
Sang Hyub Lee ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Cancer Patients ◽  
Cox Regression ◽  
Excision Repair ◽  
Cox Model ◽  
Progression Free Survival ◽  
Complementation Group ◽  
Cox Regression Analysis ◽  
Asian Patients ◽  
Damage Repair

FOLFIRINOX is currently one of the standard chemotherapy regimens for pancreatic cancer patients, but little is known about the factors that can predict a response to it. We performed a study to discover novel DNA damage repair (DDR) gene variants associated with the response to FOLFIRINOX chemotherapy in patients with pancreatic cancer. We queried a cohort of pancreatic cancer patients who received FOLFIRINOX chemotherapy as the first treatment and who had tissue obtained through an endoscopic ultrasound-guided biopsy that was suitable for DNA sequencing. We explored variants of 148 DDR genes based on whole exome sequencing and performed multivariate Cox regression to find genetic variants associated with progression-free survival (PFS). Overall, 103 patients were included. Among 2384 variants of 141 DDR genes, 612 non-synonymous variants of 123 genes were selected for Cox regression analysis. The multivariate Cox model showed that rs2228528 in ERCC6 was significantly associated with improved PFS (hazard ratio 0.54, p = 0.001). The median PFS was significantly longer in patients with rs2228528 genotype AA vs. genotype GA and GG (23.5 vs. 16.2 and 8.6 months; log-rank p < 0.001). This study suggests that rs2228528 in ERCC6 could be a potential predictor of response to FOLFIRINOX chemotherapy in patients with pancreatic cancer.

scholarly journals Symptom Relief is the Most Significant Prognostic Factor for Unresectable Locally Advanced/Recurrent Pancreatic Cancer Receiving Chemoradiotherapy: Analysis of 65 Cases

2020 ◽  
Author(s):  
Ting Jiang ◽  
Jingxian Shen ◽  
Shuang Liu ◽  
Qing Liu ◽  
Weiwei Xiao ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Prognostic Factor ◽  
Radiation Dose ◽  
Cox Regression ◽  
Symptom Relief ◽  
Locally Advanced ◽  
Rank Test ◽  
Significant Prognostic Factor ◽  
Cox Regression Analysis ◽  
Recurrent Pancreatic Cancer

Abstract BackgroundPancreatic cancer is the fourth leading cause of cancer-related death throughout the world. For local advanced and recurrent pancreatic cancer (LAPC/LRPC), chemoradiotherapy (CRT) is a main choice which may prolong their survival and ease patients’ symptoms.MethodsWe constructed a database of 65 patients with LAPC/LRPC treated from June, 2004 to February, 2018. We used log-rank test to evaluate the different overall survival (OS) rates of all factors involved, and used cox regression model to find out independent prognostic factors for these patients.ResultsThe median OS time for 65 eligible patients was 23.6 months. 47 (72.3%) and 18 (27.7%) patients had unresectable LAPC and LRPC, and median OS time was 17.2 and 40.7 months (P= 0.02), respectively. The mean biological effective dose (BED) to gross tumor volume (GTV) was 64.8Gy (46.7-85.5 Gy). 11(16.9%) and 54(83.1%) patients had BED> 72 Gy and BED≤ 72 Gy, and their mOS was 31.8 and 21.9 months (P= 0.08), respectively. Simultaneous dose boost to interval GTV (GTVin) was applied to 23 patients (35.4%). Patients with large GTV volume (≥ 109.2 cm3) may benefit from radiation dose boost (mOS: 27.6 vs. 5.3 months, P= 0.004). Patients with symptom relief including relief of pain, jaundice, and/or diarrhea had higher OS rates than those without response (mOS: 25.7 vs. 13.2 months, P< 0.01) and multivariate cox regression analysis suggested symptom relief was the most significant prognostic factor for OS (HR= 0.44, 95%CI 0.35-2.36, P= 0.02).ConclusionCRT with simultaneous integrated boost of radiation dose may bring survival benefit for LAPC/LRPC patients with bulk tumor. Symptom relief is the most significant prognostic factor for LAPC/LRPC patients after comprehensive CRT.

scholarly journals Salvage therapies for radiation-relapsed IDH-mutant astrocytoma and 1p/19q codeleted oligodendroglioma

2021 ◽  
Author(s):  
Sirui Ma ◽  
Soumon Rudra ◽  
Jian L Campian ◽  
Milan G Chheda ◽  
Tanner M Johanns ◽  
...  
Keyword(s):  
Cox Regression ◽  
Salvage Surgery ◽  
Multivariable Analysis ◽  
Progression Free Survival ◽  
Cancer Center ◽  
First Line ◽  
Free Survival ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Tertiary Cancer Center

Abstract Background Optimal management for recurrent IDH-mutant glioma after radiation therapy (RT) is not well-defined. This study assesses practice patterns for managing recurrent IDH-mutant astrocytoma (Astro) and 1p/19q codeleted oligodendroglioma (Oligo) after RT and surveys their clinical outcomes after different salvage approaches. Methods Ninety-four recurrent Astro or Oligo patients after RT who received salvage systemic therapy (SST) between 2001 and 2019 at a tertiary cancer center were retrospectively analyzed. SST was defined as either alkylating chemotherapy (AC) or non-alkylating therapy (non-AC). Overall survival (OS) and progression-free survival (PFS) were calculated using the Kaplan-Meier method from the start of SST. Multivariable analysis (MVA) was conducted using Cox regression analysis. Results Recurrent Oligo (n=35) had significantly higher PFS (median: 3.1 vs 0.8 years, respectively, P = 0.002) and OS (median: 6.3 vs 1.5 years, respectively, P &lt; 0.001) than Astro (n=59). Overall, 90% of recurrences were local. Eight-three percent received AC as the first-line SST; 50% received salvage surgery before SST; approximately 50% with local failure &gt;2 years after prior RT received reirradiation. On MVA, non-AC was associated with worse OS for both Oligo and Astro; salvage surgery was associated with improved PFS and OS for Astro; early reirradiation was associated with improved PFS for Astro. Conclusions Recurrent radiation-relapsed IDH-mutant gliomas represent a heterogeneous group with variable treatment approaches. Surgery, AC, and reirradiation remain the mainstay of salvage options for retreatment.

scholarly journals IL-11RA is a Prognostic Biomarker and Correlated with Immune Infiltration in Lung Adenocarcinoma

2021 ◽  
Author(s):  
Aitao Nai ◽  
SHOAIB BASHIR ◽  
Ling Jin ◽  
Zirui He ◽  
Shuwen Zeng ◽  
...  
Keyword(s):  
Overall Survival ◽  
Lung Adenocarcinoma ◽  
Cox Regression ◽  
Progression Free Survival ◽  
Clinicopathological Parameters ◽  
Free Survival ◽  
Cox Regression Analysis ◽  
Immune Infiltration ◽  
Potential Biomarker

Abstract Background: Interleukin-11 receptor subunit alpha (IL-11RA) contributes to multiple biological processes in various tumors. However, the role of IL-11RA in Lung adenocarcinoma (LUAD) is still undetermined. The study aims to explore the role of IL-11RA in LUAD via an integrated bioinformatics analysis. Methods: TIMER, GEPIA, TCGA and HPA databases analysis were used to detect IL-11RA expression. UALCAN database was used to analysis the correlation between IL-11RA expression and clinicopathological parameters of LUAD. Kaplan-Meier Plotter, TCGA and GEO databases were used to analysis overall survival (OS) and progression-free survival (PFS) of the LUAD patients. Univariate Cox regression analysis was used to assess the prognostic value of IL-11RA in different clinical characteristics. GSEA, and TIMER were used to investigate the relationship between IL-11RA and immune infiltration.Results: The expression of IL-11RA was down-regulated in LUAD tissues. Furthermore, IL-11RA expression was closely associated with clinical stage, lymph node stage and smoking habits. The patients with lower IL-11RA expression had poorer overall survival (OS) and progression-free survival (PFS). Lower IL-11RA expression was significantly associated with its hypermethylation, and the hypermethylation of CpG site at cg14609668 and cg21504624 was obviously correlated with poorer OS. Then, we found that IL-11RA may play an important role in LUAD progression and immune regulations. Notably, High expression of IL-11RA may suppress the progression of LUAD through inhibiting cell proliferation and immune cell infiltration, especially in B cells, CD4+ T cells, and Dendritic Cell. Conclusions: Decreased IL-11RA expression correlates with poor prognosis and immune infiltration in LUAD. Our work highlights IL-11RA might be a potential biomarker for prognosis and provide a new therapeutic target for LUAD patients.

scholarly journals Clinical characteristics and blood/serum bound prognostic biomarkers in advanced pancreatic cancer treated with gemcitabine and nab-paclitaxel

2020 ◽  
Author(s):  
Hakon Blomstrand ◽  
Henrik Green ◽  
Mats Fredriksson ◽  
Emma Gränsmark ◽  
Bergthor Björnsson ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Regression Analysis ◽  
Serum Albumin ◽  
Blood Serum ◽  
Advanced Pancreatic Cancer ◽  
Progression Free Survival ◽  
Older Age ◽  
Baseline Serum ◽  
Free Survival ◽  
Cox Regression Analysis

Abstract Background: In recent years treatment options for advanced pancreatic cancer has markedly improved, and a combination regimen of gemcitabine and nab-paclitaxel is now considered standard of care in Sweden and elsewhere. Nevertheless, a majority of patients do not respond to treatment. In order to guide the individual patient to the most beneficial therapeutic strategy, simple and easily available prognostic and predictive markers are needed. Methods: The potential prognostic value of a range of blood/serum parameters, patient-, and tumour characteristics was explored in a retrospective cohort of 75 patients treated with gemcitabine/nab-paclitaxel (Gem/NabP) for advanced pancreatic ductal adenocarcinoma (PDAC) in the South Eastern Region of Sweden. Primary outcome was overall survival while progression free survival was the key secondary outcome.Result: Univariable Cox regression analysis revealed that high baseline serum albumin (> 37 g/L) and older age (>65) were positive prognostic markers for OS, and in multivariable regression analysis both parameters were confirmed to be independent prognostic variables (HR 0.48, p=0.023 and HR=0.47, p=0.039,). Thrombocytopenia at any time during the treatment was an independent predictor for improved progression free survival (PFS) but not for OS (HR 0.49, p=0.029, 0.54, p=0.073), whereas thrombocytopenia developed under cycle 1 was neither related with OS nor PFS (HR 0.87, p=0.384, HR 1.04, p=0.771). Other parameters assessed (gender, tumour stage, ECOG performance status, myelosuppression, baseline serum CA19-9, and baseline serum bilirubin levels) were not significantly associated with survival. Conclusion: Serum albumin at baseline is a prognostic factor with palliative Gem/NabP in advanced PDAC, and should be further assessed as a tool for risk stratification. Older age was associated with improved survival, which encourages further studies on the use of Gem/NabP in the elderly.

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