BACKGROUND: Second-line (2L) chemotherapy after nab-paclitaxel plus gemcitabine (AG) is important for improving the survival of patients with advanced pancreatic cancer (APC). However, many patients fail to receive 2L chemotherapy because of rapid disease progression. Therefore, early recognition of any ineffectiveness during AG might lead to an increased induction rate of 2L chemotherapy. AIM: We investigated the significance of treatment response at 8 weeks as a predictive factor for the induction of 2L chemotherapy after AG. METHODS AND RESULTS: From January 2015 to January 2019, 41 patients with APC underwent AG as first-line chemotherapy at our institute. Thirty-three patients were evaluated at 8 weeks. Sixteen patients (48%) underwent 2L chemotherapy and 17 (52%) underwent no 2L chemotherapy. Clinical features and treatment response at 8 weeks were, retrospectively, compared among patients. Predictive factors for the induction of 2L chemotherapy were analyzed. Patients with an objective response by 8 weeks received 2L chemotherapy more frequently (P = .026). Decreased CA19-9 (<50%) at 8 weeks was identified as an independent negative predictive factor for the induction of 2L chemotherapy. CONCLUSIONS: Decreased CA19-9 (<50%) at 8 weeks may indicate the ineffectiveness of AG and signify that a move to 2L chemotherapy may be required without delay.
BACKGROUND: Second-line (2L) chemotherapy after nab-paclitaxel plus gemcitabine (AG) is important for improving the survival of patients with advanced pancreatic cancer (APC). However, many patients fail to receive 2L chemotherapy because of rapid disease progression. Therefore, early recognition of any ineffectiveness during AG might lead to an increased induction rate of 2L chemotherapy. AIM: We investigated the significance of treatment response at 8 weeks as a predictive factor for the induction of 2L chemotherapy after AG. METHODS AND RESULTS: From January 2015 to January 2019, 41 patients with APC underwent AG as first-line chemotherapy at our institute. Thirty-three patients were evaluated at 8 weeks. Sixteen patients (48%) underwent 2L chemotherapy and 17 (52%) underwent no 2L chemotherapy. Clinical features and treatment response at 8 weeks were, retrospectively, compared among patients. Predictive factors for the induction of 2L chemotherapy were analyzed. Patients with an objective response by 8 weeks received 2L chemotherapy more frequently (P = .026). Decreased CA19-9 (<50%) at 8 weeks was identified as an independent negative predictive factor for the induction of 2L chemotherapy. CONCLUSIONS: Decreased CA19-9 (<50%) at 8 weeks may indicate the ineffectiveness of AG and signify that a move to 2L chemotherapy may be required without delay.
Authors: Andrea Wang-Gillam; Chung-Pin Li; György Bodoky; Andrew Dean; Yan-Shen Shan; Gayle Jameson; Teresa Macarulla; Kyung-Hun Lee; David Cunningham; Jean F Blanc; Richard A Hubner; Chang-Fang Chiu; Gilberto Schwartsmann; Jens T Siveke; Fadi Braiteh; Victor Moyo; Bruce Belanger; Navreet Dhindsa; Eliel Bayever; Daniel D Von Hoff; Li-Tzong Chen Journal: Lancet Date: 2015-11-29 Impact factor: 79.321
Authors: Helmut Oettle; Hanno Riess; Jens M Stieler; Gerhard Heil; Ingo Schwaner; Jörg Seraphin; Martin Görner; Matthias Mölle; Tim F Greten; Volker Lakner; Sven Bischoff; Marianne Sinn; Bernd Dörken; Uwe Pelzer Journal: J Clin Oncol Date: 2014-06-30 Impact factor: 44.544
Authors: Josep Tabernero; E Gabriela Chiorean; Jeffrey R Infante; Sunil R Hingorani; Vinod Ganju; Colin Weekes; Werner Scheithauer; Ramesh K Ramanathan; David Goldstein; Darryl N Penenberg; Alfredo Romano; Stefano Ferrara; Daniel D Von Hoff Journal: Oncologist Date: 2015-01-12
Authors: E G Chiorean; D D Von Hoff; M Reni; F P Arena; J R Infante; V G Bathini; T E Wood; P N Mainwaring; R T Muldoon; P R Clingan; V Kunzmann; R K Ramanathan; J Tabernero; D Goldstein; D McGovern; B Lu; A Ko Journal: Ann Oncol Date: 2016-01-22 Impact factor: 32.976