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Overall survival of patients with recurrent pancreatic cancer treated with systemic therapy: a retrospective study

Title: Overall survival of patients with recurrent pancreatic cancer treated with systemic therapy: a retrospective study
Authors: Gbolahan, Olumide B.; Tong, Yan; Sehdev, Amikar; O’Neil, Bert; Shahda, Safi
Contributors: Medicine, School of Medicine
Source: PMC
Publisher Information: Springer Nature
Publication Year: 2019
Collection: Indiana University - Purdue University Indianapolis: IUPUI Scholar Works
Subject Terms: Combination chemotherapy; FOLFIRINOX; Gemcitabine-nab paclitaxel; Metastatic pancreatic cancer; Recurrent pancreatic cancer; Recurrent pancreatic ductal adenocarcinoma
Description: BACKGROUND: Only a few patients with pancreatic ductal adenocarcinoma (PDAC) recurring after curative resection and peri-operative (neoadjuvant and adjuvant) therapy are included in clinical trials of metastatic PDAC. As such, there is a paucity of data to guide treatment after relapse, and patients are treated similarly to those with de novo metastatic PDAC (mPDAC). We evaluated the patterns of chemotherapy use and over-all survival (OS) in patients with recurrent PDAC (rPDAC) following curative therapy. METHODS: In this retrospective study, the Indiana University pancreatic cancer database was used to identify patients with PDAC who underwent curative resection and subsequently developed recurrence. Demographics, tumor and treatment characteristics were collected. Patients were broadly divided into those who received chemotherapy for rPDAC and those who did not. Patients in the former category were further subdivided into those who received single agent therapy, any standard combination therapy (5-fluorouracil/irinotecan/oxaliplatin combination or gemcitabine/nab-paclitaxel) and those who received non-standard combinations. Survival analysis was performed by the Kaplan-Meier method. Log rank tests were used to determine differences in survival between treated rPDAC patients and those not treated. Cox regression analysis was employed to evaluate factors associated with OS. RESULTS: We identified 435 patients with resected PDAC treated between 2008 and 2014. Two hundred and twenty-three patients (51.2%) were diagnosed with rPDAC. Of these, 140 patients (63%) received chemotherapy whereas 71 patients (32%) did not receive chemotherapy. The 74 patients (53%) who received any standard, approved multiagent combination regimen had a median OS of 14 months compared to 8 months for the 47 patents (34%) who received other non-standard combinations and the 19 (13%) who received single agent therapy (P = 0.029). Multivariate cox regression analysis showed that margin negative resection, peri-operative therapy, ...
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
Relation: BMC Cancer; https://hdl.handle.net/1805/20513
Availability: https://hdl.handle.net/1805/20513
Rights: Attribution-NonCommercial-NoDerivs 3.0 United States ; http://creativecommons.org/licenses/by-nc-nd/3.0/us/
Accession Number: edsbas.76AD1FF9
Database: BASE