A Prognostic Model to Identify Patients with Advanced Pancreas Adenocarcinoma Who Could Benefit from Second-line Chemotherapy

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Abstract

Aims: The role of salvage chemotherapy after first-line therapy in advanced pancreatic cancer has not yet been established. We intended to identify prognostic factors for long-term survival of advanced pancreatic adenocarcinoma patients with second-line chemotherapy and to devise a prognostic model of clinical parameters. Patients and methods: We analysed 90 patients who had received second-line chemotherapy after the failure of first-line therapy in recurrent or metastatic pancreatic adenocarcinoma between August 2003 and December 2008. Results: The median age at the time of second-line chemotherapy was 61.9 years (range 39.8-74.9) and the median Eastern Cooperative Oncology Group (ECOG) performance status was 1 (0-2). Median progression-free survival and overall survival for second-line chemotherapy were 2.1 and 4.5 months, respectively, with an overall response rate of 10%. In multivariate analysis, an ECOG performance status of 2 or more, non-responder for first-line chemotherapy and albumin level of <3.5. mg/dl were independent prognostic factors for decreased overall survival for all 90 patients. Overall survival was estimated based on the number of adverse prognostic factors: zero or one (good prognostic group), two (intermediate group) or three (poor prognostic group). The median overall survival for good (n = 50), intermediate (n = 24) and poor (n = 16) prognostic groups was 5.5, 3.3 and 2.1 months, respectively (P< 0.001). Conclusion: Our result suggests that second-line chemotherapy may be beneficial for overall survival in patients with ECOG performance status 0-1, albumin level ≥3.5. mg/dl and response to first-line chemotherapy.

Original languageEnglish
Pages (from-to)105-111
Number of pages7
JournalClinical Oncology
Volume24
Issue number2
DOIs
Publication statusPublished - 2012 Mar 1

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Pancreas
Adenocarcinoma
Drug Therapy
Survival
Albumins
Pancreatic Neoplasms
Disease-Free Survival
Multivariate Analysis
Therapeutics

Keywords

  • Pancreatic adenocarcinoma
  • Prognostic model
  • Second-line chemotherapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

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title = "A Prognostic Model to Identify Patients with Advanced Pancreas Adenocarcinoma Who Could Benefit from Second-line Chemotherapy",
abstract = "Aims: The role of salvage chemotherapy after first-line therapy in advanced pancreatic cancer has not yet been established. We intended to identify prognostic factors for long-term survival of advanced pancreatic adenocarcinoma patients with second-line chemotherapy and to devise a prognostic model of clinical parameters. Patients and methods: We analysed 90 patients who had received second-line chemotherapy after the failure of first-line therapy in recurrent or metastatic pancreatic adenocarcinoma between August 2003 and December 2008. Results: The median age at the time of second-line chemotherapy was 61.9 years (range 39.8-74.9) and the median Eastern Cooperative Oncology Group (ECOG) performance status was 1 (0-2). Median progression-free survival and overall survival for second-line chemotherapy were 2.1 and 4.5 months, respectively, with an overall response rate of 10{\%}. In multivariate analysis, an ECOG performance status of 2 or more, non-responder for first-line chemotherapy and albumin level of <3.5. mg/dl were independent prognostic factors for decreased overall survival for all 90 patients. Overall survival was estimated based on the number of adverse prognostic factors: zero or one (good prognostic group), two (intermediate group) or three (poor prognostic group). The median overall survival for good (n = 50), intermediate (n = 24) and poor (n = 16) prognostic groups was 5.5, 3.3 and 2.1 months, respectively (P< 0.001). Conclusion: Our result suggests that second-line chemotherapy may be beneficial for overall survival in patients with ECOG performance status 0-1, albumin level ≥3.5. mg/dl and response to first-line chemotherapy.",
keywords = "Pancreatic adenocarcinoma, Prognostic model, Second-line chemotherapy",
author = "Kim, {Seung Tae} and Choi, {Yoon Ji} and Park, {Kyong Hwa} and Oh, {Sang Cheul} and Seo, {Jae Hong} and Shin, {Sang Won} and Kim, {Jun Suk} and Kim, {Yeul Hong}",
year = "2012",
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doi = "10.1016/j.clon.2011.02.005",
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pages = "105--111",
journal = "Clinical Oncology",
issn = "0936-6555",
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TY - JOUR

T1 - A Prognostic Model to Identify Patients with Advanced Pancreas Adenocarcinoma Who Could Benefit from Second-line Chemotherapy

AU - Kim, Seung Tae

AU - Choi, Yoon Ji

AU - Park, Kyong Hwa

AU - Oh, Sang Cheul

AU - Seo, Jae Hong

AU - Shin, Sang Won

AU - Kim, Jun Suk

AU - Kim, Yeul Hong

PY - 2012/3/1

Y1 - 2012/3/1

N2 - Aims: The role of salvage chemotherapy after first-line therapy in advanced pancreatic cancer has not yet been established. We intended to identify prognostic factors for long-term survival of advanced pancreatic adenocarcinoma patients with second-line chemotherapy and to devise a prognostic model of clinical parameters. Patients and methods: We analysed 90 patients who had received second-line chemotherapy after the failure of first-line therapy in recurrent or metastatic pancreatic adenocarcinoma between August 2003 and December 2008. Results: The median age at the time of second-line chemotherapy was 61.9 years (range 39.8-74.9) and the median Eastern Cooperative Oncology Group (ECOG) performance status was 1 (0-2). Median progression-free survival and overall survival for second-line chemotherapy were 2.1 and 4.5 months, respectively, with an overall response rate of 10%. In multivariate analysis, an ECOG performance status of 2 or more, non-responder for first-line chemotherapy and albumin level of <3.5. mg/dl were independent prognostic factors for decreased overall survival for all 90 patients. Overall survival was estimated based on the number of adverse prognostic factors: zero or one (good prognostic group), two (intermediate group) or three (poor prognostic group). The median overall survival for good (n = 50), intermediate (n = 24) and poor (n = 16) prognostic groups was 5.5, 3.3 and 2.1 months, respectively (P< 0.001). Conclusion: Our result suggests that second-line chemotherapy may be beneficial for overall survival in patients with ECOG performance status 0-1, albumin level ≥3.5. mg/dl and response to first-line chemotherapy.

AB - Aims: The role of salvage chemotherapy after first-line therapy in advanced pancreatic cancer has not yet been established. We intended to identify prognostic factors for long-term survival of advanced pancreatic adenocarcinoma patients with second-line chemotherapy and to devise a prognostic model of clinical parameters. Patients and methods: We analysed 90 patients who had received second-line chemotherapy after the failure of first-line therapy in recurrent or metastatic pancreatic adenocarcinoma between August 2003 and December 2008. Results: The median age at the time of second-line chemotherapy was 61.9 years (range 39.8-74.9) and the median Eastern Cooperative Oncology Group (ECOG) performance status was 1 (0-2). Median progression-free survival and overall survival for second-line chemotherapy were 2.1 and 4.5 months, respectively, with an overall response rate of 10%. In multivariate analysis, an ECOG performance status of 2 or more, non-responder for first-line chemotherapy and albumin level of <3.5. mg/dl were independent prognostic factors for decreased overall survival for all 90 patients. Overall survival was estimated based on the number of adverse prognostic factors: zero or one (good prognostic group), two (intermediate group) or three (poor prognostic group). The median overall survival for good (n = 50), intermediate (n = 24) and poor (n = 16) prognostic groups was 5.5, 3.3 and 2.1 months, respectively (P< 0.001). Conclusion: Our result suggests that second-line chemotherapy may be beneficial for overall survival in patients with ECOG performance status 0-1, albumin level ≥3.5. mg/dl and response to first-line chemotherapy.

KW - Pancreatic adenocarcinoma

KW - Prognostic model

KW - Second-line chemotherapy

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U2 - 10.1016/j.clon.2011.02.005

DO - 10.1016/j.clon.2011.02.005

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JO - Clinical Oncology

JF - Clinical Oncology

SN - 0936-6555

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