Outcomes with second-line chemotherapy in advanced pancreatic cancers: A retrospective study from a tertiary cancer center in India

Ramaswamy, Anant; Parthiban, Sangeetha; Malhotra, Mridul; Kothari, Rushabh; Goel, Alok; Bhargava, Prabhat; Srinivas, Sujay; Kulkarni, Suyash; Ostwal, Vikas

doi:10.4103/ijc.ijc_553_17

Cited by 3 publications

(1 citation statement)

References 17 publications

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“…Hence, the present study retrospectively analyzed the clinical characteristics and outcomes of subsequent chemotherapy in patients with advanced pancreatic cancer after the failure of initial chemotherapy in clinical practice. The median OS after the start of second-line chemotherapy was 6.4 months (95% CI, 4.5-8.6 months), similar to the recent retrospective reports of second-line chemotherapy for advanced pancreatic cancer in the real-world setting (5.2-8.1 months) [8][9][10]. Excellent PS, locally advanced disease, and normal CEA level at the time of second-line treatment initiation were associated with better OS.…”

Section: Discussionsupporting

confidence: 82%

The clinical outcomes of second-line chemotherapy in patients with advanced pancreatic cancer: a retrospective study

Jung

Lee

2022

J Yeungnam Med Sci

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Background: Despite recent advances in first-line chemotherapy for advanced pancreatic cancer, standard treatment after the failure of initial chemotherapy has not been established. Hence, we aimed to retrospectively analyze the clinical characteristics and outcomes of second-line chemotherapy in patients with advanced pancreatic cancer. Methods: We reviewed the clinical data of patients with advanced pancreatic cancer who underwent palliative chemotherapy at Kosin University Gospel Hospital between January 2013 and October 2020. Results: Among 366 patients with advanced pancreatic cancer who had received palliative chemotherapy, 104 (28.4%) underwent at least one cycle of second-line chemotherapy. The median age of the patients at the time of initiating second-line treatment was 62 years (interquartile range, 57-62 years), and 58.7% (61 patients) of them were male. The common second-line chemotherapy regimens were 5-fluorouracil (FU) plus leucovorin, irinotecan, and oxaliplatin (33 patients, 31.7%); gemcitabine/nab-paclitaxel (29, 27.9%), gemcitabine ±erlotinib (13, 12.5%); and oxaliplatin and 5-FU/leucovorin (12, 11.5%). The median overall survival (OS) and progression-free survival were 6.4 months (95% confidence interval [CI], 4.5-8.6 months) and 4.5 months (95% CI, 2.7-6.3 months), respectively. In a multivariate analysis, poor performance status (PS) (hazard ratio [HR], 2.247; p= 0.021), metastatic disease (HR, 2.745; p= 0.011), and elevated carcinoembryonic antigen (CEA) levels (HR, 1.939; p = 0.030) at the beginning of second-line chemotherapy were associated with poor OS. Conclusion: The survival outcome of second-line chemotherapy for advanced pancreatic cancer remains poor. However, PS, disease extent (locally advanced or metastatic), and CEA level may help determine patients who could benefit from second-line treatment.

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Section: Discussionsupporting

confidence: 82%

The clinical outcomes of second-line chemotherapy in patients with advanced pancreatic cancer: a retrospective study

Jung

Lee

2022

J Yeungnam Med Sci

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Adjuvant therapy may improve overall survival in high-risk periampullary adenocarcinomas patients – A match-pair analysis from a multi-institutional cohort study (The MIPPAP study)

Ramaswamy,

Chaudhari,

Srinivas

et al. 2024

HPB

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Systemic therapy in pancreatic ductal adenocarcinomas (PDACs)—basis and current status

Ramaswamy¹,

Srinivas²,

Chaudhari³

et al. 2022

ecancer

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A major shift in the approach to the management of pancreatic ductal adenocarcinomas (PDACs) has been the recognition of the systemic nature of the disease even in clinically and radiologically limited disease stages. The recalcitrant nature of PDAC is intrinsically related to the lack of therapeutic targets and dense surrounding stroma that limits the activity of currently available chemotherapeutic options. However, research is increasingly focusing on intensifying systemic management options in PDAC, resulting in gradual improvements in survival. Currently effective chemotherapeutic regimens like modified 5-fluorouracil-leucovorin-irinotecan-oxaliplatin and gemcitabine-nab-paclitaxel have improved outcomes in resectable and advanced PDAC. An increasing use of these regimens has also resulted in greater conversion of borderline resectable and locally advanced cancers to resection, though the most effective approach in this subgroup is yet to be identified. The current review presents an outline of the basic systemic nature of PDAC and current options of systemic therapy, predominantly chemotherapy .

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Outcomes with second-line chemotherapy in advanced pancreatic cancers: A retrospective study from a tertiary cancer center in India

Cited by 3 publications

References 17 publications

The clinical outcomes of second-line chemotherapy in patients with advanced pancreatic cancer: a retrospective study

The clinical outcomes of second-line chemotherapy in patients with advanced pancreatic cancer: a retrospective study

Adjuvant therapy may improve overall survival in high-risk periampullary adenocarcinomas patients – A match-pair analysis from a multi-institutional cohort study (The MIPPAP study)

Systemic therapy in pancreatic ductal adenocarcinomas (PDACs)—basis and current status

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