A multi-centre retrospective review of second-line therapy in advanced pancreatic adenocarcinoma

• Published in: Cancer chemotherapy and pharmacology Vol. 62; no. 4; pp. 673 - 678
• Main Authors: Reni, M., Berardi, R., Mambrini, A., Pasetto, L., Cereda, S., Ferrari, V. D., Cascinu, S., Cantore, M., Mazza, E., Grisanti, S.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.09.2008; Springer; Springer Nature B.V
• Subjects: Adenocarcinoma - mortality; Adenocarcinoma - secondary; Adenocarcinoma - therapy; Adult; Aged; Aged, 80 and over; Antineoplastic agents; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Cancer Research; Chemotherapy, Adjuvant; Combined Modality Therapy; Deoxycytidine - analogs & derivatives; Deoxycytidine - therapeutic use; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Recurrence, Local; Oncology; Original Article; Pancreatic Neoplasms - mortality; Pancreatic Neoplasms - pathology; Pancreatic Neoplasms - therapy; Pharmacology. Drug treatments; Pharmacology/Toxicology; Prognosis; Retrospective Studies; Salvage Therapy; Survival Rate; Treatment Failure; Tumors; Gemcitabine-refractory cancer; Chemotherapy; Pancreatic cancer; Second-line therapy; Antineoplastic agent; Treatment resistance; Gemcitabine; Malignant tumor; Chemotherapy, Pancreatic cancer; Treatment; Antimetabolic; Follow up study; Pancreas cancer; Pyrimidine derivatives; Digestive diseases; Advanced stage; Second line treatment; Second-line therapy; Gemcitabine-refractory cancer; Fluorine Organic compounds; Pyrimidine nucleoside; Pancreas adenocarcinoma; Cancer; Pancreatic disease
• ISSN: 0344-5704; 1432-0843
• DOI: 10.1007/s00280-007-0653-y

Introduction Limited information on second-line treatment in patients with pancreatic adenocarcinoma is available. At time of first-line treatment failure, approximately half of the patients are candidates for further treatment. Material and methods A retrospective review of 183 patients submitted to second-line therapy has been performed to identify prognostic factors, provides useful information for patients counseling and generates hypotheses for future studies. Inclusion criteria were: cytological or histologic diagnosis of pancreatic adenocarcinoma and prior gemcitabine-including chemotherapy. Any age, performance status (PS) and chemotherapy regimen were considered. Results One hundred and eighty-three patients (106 males; 168 metastatic; median age 62 years; median PS 1; 63 submitted to prior curative surgery, 32 to prior radiotherapy) with a median previous progression-free survival (PFS) of 6.7 months were included. Median and 6-month PFS after initiation of salvage therapy were 3.0 months and 20%. Median, 1 and 2 years, overall survival after initiation of salvage therapy were 6.2 months, 17 and 4%, respectively. Previous PFS, CA19.9 levels and age independently predicted OS. Conclusion Re-challenge with gemcitabine and 5-fluorouracil administration may have a role in selected patients.