Journal
CANCER CHEMOTHERAPY AND PHARMACOLOGY
Volume 62, Issue 4, Pages 673-678Publisher
SPRINGER
DOI: 10.1007/s00280-007-0653-y
Keywords
chemotherapy; pancreatic cancer; second-line therapy; gemcitabine-refractory cancer
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Introduction Limited information on second-line treatment in patients with pancreatic adenocarcinoma is available. At time of first-line treatment failure, approximately half of the patients are candidates for further treatment. Material and methods A retrospective review of 183 patients submitted to second-line therapy has been performed to identify prognostic factors, provides useful information for patients counseling and generates hypotheses for future studies. Inclusion criteria were: cytological or histologic diagnosis of pancreatic adenocarcinoma and prior gemcitabine-including chemotherapy. Any age, performance status (PS) and chemotherapy regimen were considered. Results One hundred and eighty-three patients (106 males; 168 metastatic; median age 62 years; median PS 1; 63 submitted to prior curative surgery, 32 to prior radiotherapy) with a median previous progression-free survival (PFS) of 6.7 months were included. Median and 6-month PFS after initiation of salvage therapy were 3.0 months and 20%. Median, 1 and 2 years, overall survival after initiation of salvage therapy were 6.2 months, 17 and 4%, respectively. Previous PFS, CA19.9 levels and age independently predicted OS. Conclusion Re-challenge with gemcitabine and 5-fluorouracil administration may have a role in selected patients.
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