Real World First-Line Treatments and Outcomes of Nab-Paclitaxel Plus Gemcitabine, mFOLFIRINOX and GEMOX in Unresectable Pancreatic Cancer from a Chinese Single Institution
Abstract
:1. Introduction
2. Patients and Methods
2.1. Patient Inclusion
2.2. Patient Information Collection
2.3. Treatment and Response Assessment
2.4. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. Efficacy and Survival
3.3. Subsequent Anticancer Treament
3.4. Univariate and Multivariate Analyses
3.5. Safety
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Characteristics | Nab-Paclitaxel-Gemcitabine | mFOLFIRINOX | GEMOX | p-Value |
---|---|---|---|---|
No. of cases | 62 | 30 | 25 | |
Age at diagnosis (years) | 0.23 | |||
<65 | 45(73) | 26(87) | 21(84) | |
≥65 | 17(27) | 4(13) | 4(16) | |
Gender | 0.80 | |||
Male | 43(69) | 22(73) | 19(76) | |
Female | 19(21) | 8(27) | 6(24) | |
ECOG PS | 0.28 | |||
0–1 | 53(85) | 29(97) | 22(88) | |
2 | 9(15) | 1(3) | 3(12) | |
Pancreatic tumor location | 0.17 | |||
Head | 19(31) | 12(40) | 13(52) | |
Body/Tail | 43(69) | 18(60) | 12(48) | |
Liver metastasis | < 0.01 | |||
Yes | 32(52) | 29(97) | 19(76) | |
No | 30(48) | 1(3) | 6(24) | |
Number of metastatic sites | 0.98 | |||
<2 | 42(68) | 21(70) | 17(68) | |
≥2 | 20(32) | 9(30) | 8(32) | |
diabetes | 0.80 | |||
Yes | 48(77) | 25(83) | 20(80) | |
No | 14(23) | 5(17) | 5(20) | |
Tumor histological grade a | 0.14 | |||
High or moderate | 20(44) | 12(41) | 4(19) | |
Low | 26(56) | 17(59) | 17(81) | |
CA19–9 (ng/mL) b | 0.73 | |||
≤35 | 13(22) | 5(17) | 4(18) | |
<35 | 45(78) | 24(83) | 18(82) | |
Disease status on study (stage) | 0.05 | |||
Locally advanced (III) | 11(18) | 1(3) | 1(4) | |
Metastatic (IV) | 51(82) | 29(97) | 24(96) | |
Second-line therapy | 0.26 | |||
Yes | 34(55) | 11(37) | 12(48) | |
No | 28(45) | 19(63) | 13(52) |
Nab-Paclitaxel-Gemcitabine | mFOLFIRINOX | GEMOX | p-Value | |
---|---|---|---|---|
Total cases | 62 | 30 | 25 | |
treatment cycles (median) | 4 | 6 | 4 | |
PR, n (%) | 15(24) | 8(27) | 8(32) | 0.76 |
SD, n (%) | 36(58) | 10(33) | 8(32) | 0.02 |
PD, n (%) | 11(18) | 12(40) | 9(36) | 0.04 |
ORR a, n (%) | 15(24) | 8(27) | 8(32) | 0.76 |
DCR b, n (%) | 51(82) | 18(60) | 16(64) | 0.04 |
Median PFS (months) | 4.9 | 3.7 | 4.7 | 0.35 |
6 mo (%) | 34.5 | 25.6 | 40.1 | 0.47 |
12 mo (%) | 9.2 | 4.3 | 26.8 | 0.44 |
Median OS (months) | 11.1 | 10.1 | 10.2 | 0.75 |
6 mo (%) | 79.6 | 67.2 | 83.5 | 0.14 |
12 mo (%) | 47.0 | 39.6 | 37.6 | 0.88 |
18 mo (%) | 23.6 | 19.8 | 12.5 | 0.87 |
24 mo (%) | 8.8 | 6.6 | 8.3 | 0.73 |
Parameter | PFS | OS | ||||
---|---|---|---|---|---|---|
Univariate Analysis | Multivariate Analysis | Univariate Analysis | Multivariate Analysis | |||
p-value | RR (95% CI) | p-value | p-value | RR (95% CI) | p-value | |
Age ≥ 65 years | 0.44 | 0.10 | ||||
Gender(male) | 0.11 | 1.82(1.09–3.02) | 0.02 | 0.04 | 1.79 (1.03–2.83) | 0.04 |
ECOG PS ≥ 2 | 0.28 | 0.55 | ||||
Pancreatic tumor location | 0.54 | 0.40 | ||||
Liver metastasis | 0.01 | 0.06 | ||||
Number of metastatic sites ≥ 2 | 0.15 | 0.13 | ||||
diabetes CA19-9(>629.5 ng/mL) | 0.21 0.80 | 0.96 0.05 | ||||
Stage IV | <0.01 | 2.61(1.05–6.49) | 0.04 | 0.20 | ||
Second-line chemotherapy | 0.86 | 0.07 |
Nab-Paclitaxel Plus Gem | mFOLFIRINOX | GEMOX | |
---|---|---|---|
Patients assessed (n) | 56 | 25 | 22 |
Total grade ≥ 3 AEs (n) | 28 | 13 | 6 |
Hematologic AEs | |||
Neutropenia (%) | 18(32) | 7(28) | 1(5) |
Leukopenia (%) | 14(25) | 5(20) | 1(5) |
Thrombocytopenia (%) | 2(4) | 1(4) | 4(18) |
Anemia (%) | 8(14) | 7(28) | 2(9) |
Receipt of growth factors | 12(21) | 5(20) | 2(9) |
Febrile neutropenia | 1(2) | 1(4) | 1(5) |
Nonhematologic AEs a | |||
Peripheral neuropathy (%) | 7(13) | 4(16) | 0(0) |
Fatigue (%) | 5(9) | 4(16) | 1(5) |
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Quan, Q.; Wang, Y.; Wang, F.; Zhang, D.; Chen, X.; He, W.; Zhang, B.; Guo, G. Real World First-Line Treatments and Outcomes of Nab-Paclitaxel Plus Gemcitabine, mFOLFIRINOX and GEMOX in Unresectable Pancreatic Cancer from a Chinese Single Institution. Curr. Oncol. 2021, 28, 209-219. https://doi.org/10.3390/curroncol28010023
Quan Q, Wang Y, Wang F, Zhang D, Chen X, He W, Zhang B, Guo G. Real World First-Line Treatments and Outcomes of Nab-Paclitaxel Plus Gemcitabine, mFOLFIRINOX and GEMOX in Unresectable Pancreatic Cancer from a Chinese Single Institution. Current Oncology. 2021; 28(1):209-219. https://doi.org/10.3390/curroncol28010023
Chicago/Turabian StyleQuan, Qi, Yixing Wang, Fenghua Wang, Dongsheng Zhang, Xiuxing Chen, Wenzhuo He, Bei Zhang, and Guifang Guo. 2021. "Real World First-Line Treatments and Outcomes of Nab-Paclitaxel Plus Gemcitabine, mFOLFIRINOX and GEMOX in Unresectable Pancreatic Cancer from a Chinese Single Institution" Current Oncology 28, no. 1: 209-219. https://doi.org/10.3390/curroncol28010023