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JYMS : Journal of Yeungnam Medical Science

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Hyun yeb Jung 1 Article
The clinical outcomes of second-line chemotherapy in patients with advanced pancreatic cancer: a retrospective study
Hyun yeb Jung, Eun Mi Lee
J Yeungnam Med Sci. 2022;39(2):124-132.   Published online October 19, 2021
DOI: https://doi.org/10.12701/yujm.2021.01347
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AbstractAbstract PDF
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.

Citations

Citations to this article as recorded by  
  • Efficacy and tolerance of LV5FU2-carboplatin chemotherapy in patients with advanced pancreatic ductal adenocarcinoma after failure of standard regimens
    Thomas Chaigneau, Lina Aguilera Munoz, Caroline Oger, Clémence Gourdeau, Olivia Hentic, Lucie Laurent, Nelly Muller, Marco Dioguardi Burgio, Marie-Pauline Gagaille, Philippe Lévy, Vinciane Rebours, Pascal Hammel, Louis de Mestier
    Therapeutic Advances in Medical Oncology.2023; 15: 175883592311637.     CrossRef
  • Real-Life Results of Palliative Chemotherapy in Metastatic Pancreatic Ductal Adenocarcinoma
    Bianca Varzaru, Razvan A. Iacob, Adina E. Croitoru, Speranta M. Iacob, Cristina E. Radu, Stefania M. Dumitrescu, Cristian Gheorghe
    Cancers.2023; 15(13): 3500.     CrossRef

JYMS : Journal of Yeungnam Medical Science