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Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:

2023 09

Page:

1690-1695

Research Field:

Publishing date:

Info

Title:

Real-world clinical efficacy of common first-line chemotherapy regimens for advanced pancreatic cancer

Author(s):

SUN Ning; FAN Xiaona; LI Hengzhen; ZHANG Wenjing; LIU Jinshuang; DAI Yisheng; JIANG Dan; LI Zhiwei

Department of Gastrointestinal Oncology,Harbin Medical University Cancer Hospital,Heilongjiang Harbin 150081,China.

Keywords:

advanced pancreatic cancer; clinical efficacy; adverse events; prognostic analysis

PACS:

R735.9

DOI:

10.3969/j.issn.1672-4992.2023.09.020

Abstract:

Objective:To compare the efficacy and safety of nab-paclitaxel combined with gemcitabine (AG),nab-paclitaxel combined with S-1 (AS),gemcitabine combined with oxaliplatin (GEMOX),and gemcitabine combined with S-1 (GS) regimens in the real-world first-line treatment of advanced pancreatic cancer.Methods:The data of 165 patients with advanced pancreatic cancer from January 2016 to June 2021 were analyzed retrospectively.According to different chemotherapy regimens,they were divided into four groups:AG group (n=40),AS group (n=31),GEMOX group (n=31),and GS group (n=63).The clinical efficacy and safety were evaluated according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 and Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.The primary end points were overall survival (OS) and progression-free survival (PFS).The secondary end points were objective response rate (ORR),disease control rate (DCR),and treatment-related adverse events.Cox regression analysis was performed on the factors that may affect the overall survival of patients.Results:The median OS of 165 patients was 10.5 months and the median PFS was 6.0 months.The median OS of AG,AS,GEMOX,and GS were 8.4,11.4,9.0,and 11.2 months,respectively (P=0.048).The median PFS of AG,AS,GEMOX,and GS regimens were 5.1,6.1,5.8,and 7.2 months,respectively (P=0.280).The median OS and PFS were relatively long in the AS and GS groups.The ORR of patients in the four groups reached 27.5%,32.3%,29.0%,and 30.2%,respectively (P=0.977).The DCR of the four groups were 70.0%,80.6%,67.7%,and 79.4%,respectively (P=0.461).AS and GS regimens had better disease control rate,which was significantly better than AG and GEMOX regimens.In addition,the incidence of side effects of chemotherapy such as rash,bone marrow suppression,and gastrointestinal reaction in AG,AS,GEMOX,and GS regimens was similar,and the difference was not statistically significant (P>0.05).Univariate analysis showed that chemotherapy regimen,initial liver metastasis,CEA value,CA19-9 value,and the number of chemotherapy cycles were the prognostic factors of pancreatic cancer (P£¼0.05).Multivariate analysis showed that CA19-9 ¡Ý 1 000 U/mL (HR=1.68£¬95%CI:1.12~2.51,P£¼0.05),GS regimen (HR=0.56,95%CI:0.36~0.87,P£¼0.05),and the number of chemotherapy cycles ¡Ý 4 (HR=0.50,95%CI:0.35~0.70,P£¼0.001) were independent prognostic factors for pancreatic cancer.Conclusion:GS and AS regimens can obtain better clinical efficacy in the first-line treatment of advanced pancreatic cancer,and their safety is equivalent to other regimens,which is worthy of clinical exploration and application.

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Last Update: 2023-03-30