Ana Fernández Montes1, Paula González Villarroel2, Manuel Valladares Ayerbes3, Juan De la Cámara Gómez4, Guillermo Quintero Aldana5, Lidia Vázquez Tuñas6, Mercedes Salgado Fernández1, Mónica Jorge Fernández2. 1. Departament of Medical Oncology, Complexo Hospitalario Universitario de Ourense, Ourense, Spain. 2. Departament of Medical Oncology, Complexo Hospitalario Universitario de Vigo, Pontevedra, Spain. 3. Departament of Medical Oncology, Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain. 4. Departament of Medical Oncology, Complexo Hospitalario Universitario de Ferrol, Ferrol, A Coruña, Spain. 5. Departament of Medical Oncology, Hospital Lucus Augusti, Lugo, Spain. 6. Departament of Medical Oncology, Hospital de Pontevedra, Pontevedra, Spain.
Abstract
BACKGROUND: Recent studies support the use of gemcitabine and nab-paclitaxel in adults with locally advanced unresectable or metastatic pancreatic adenocarcinoma although insufficient data are available on prognostic and predictive markers of response to treatment. OBJECTIVE: The objective of this study is to identify treatment response markers in patients with locally advanced unresectable or metastatic pancreatic adenocarcinoma. MATERIALS AND METHODS: This is an observational, retrospective, and multicenter study. Sociodemographic, clinical, and therapeutic data were collected. Cox regression models were applied to determine associations. RESULTS: In total, 39 patients were included; 23.1% presented locally advanced pancreatic cancer and 76.9% metastatic disease. They received a mean of 6 ± 3 treatment cycles; 59% required dose reduction, 59% treatment delay, and 20.5% switched to a biweekly regimen. The overall response rate was 23% and the disease control rate was 81%. Median progression-free survival was 9 months and median overall survival (OS) was 15 months. A higher neutrophil/lymphocyte ratio (NLR) was significantly associated with lower OS. We reported Grades 1-4 nonhematological and hematological toxicities. CONCLUSION: NLR is a useful prognostic factor for OS in patients with locally advanced unresectable or metastatic pancreatic adenocarcinoma treated with gemcitabine and nab-paclitaxel. Moreover, we suggest that a biweekly regimen is an option for certain groups of patients.
BACKGROUND: Recent studies support the use of gemcitabine and nab-paclitaxel in adults with locally advanced unresectable or metastatic pancreatic adenocarcinoma although insufficient data are available on prognostic and predictive markers of response to treatment. OBJECTIVE: The objective of this study is to identify treatment response markers in patients with locally advanced unresectable or metastatic pancreatic adenocarcinoma. MATERIALS AND METHODS: This is an observational, retrospective, and multicenter study. Sociodemographic, clinical, and therapeutic data were collected. Cox regression models were applied to determine associations. RESULTS: In total, 39 patients were included; 23.1% presented locally advanced pancreatic cancer and 76.9% metastatic disease. They received a mean of 6 ± 3 treatment cycles; 59% required dose reduction, 59% treatment delay, and 20.5% switched to a biweekly regimen. The overall response rate was 23% and the disease control rate was 81%. Median progression-free survival was 9 months and median overall survival (OS) was 15 months. A higher neutrophil/lymphocyte ratio (NLR) was significantly associated with lower OS. We reported Grades 1-4 nonhematological and hematological toxicities. CONCLUSION: NLR is a useful prognostic factor for OS in patients with locally advanced unresectable or metastatic pancreatic adenocarcinoma treated with gemcitabine and nab-paclitaxel. Moreover, we suggest that a biweekly regimen is an option for certain groups of patients.
Authors: Ana Fernández; Mercedes Salgado; Adelaida García; Elvira Buxò; Ruth Vera; Jorge Adeva; Paula Jiménez-Fonseca; Guillermo Quintero; Cristina Llorca; Mamen Cañabate; Luis Jesús López; Andrés Muñoz; Patricia Ramírez; Paula González; Carlos López; Margarita Reboredo; Elena Gallardo; Manuel Sanchez-Cánovas; Javier Gallego; Carmen Guillén; Nuria Ruiz-Miravet; Víctor Navarro-Pérez; Juan De la Cámara; Inmaculada Alés-Díaz; Roberto Antonio Pazo-Cid; Alberto Carmona-Bayonas Journal: BMC Cancer Date: 2018-11-29 Impact factor: 4.430