Short time to progression under first-line chemotherapy is a negative prognostic factor for time to progression and residual survival under second-line chemotherapy in advanced pancreatic cancer

Objectives: Second-line chemotherapy is widely used in advanced pancreatic cancer. However, only few data exist concerning the question who might benefit from second-line therapy. We intended to identify prognostic factors for time to second progression (TTP2) and residual survival following second-line chemotherapy of patients with advanced pancreatic cancer. Methods: We performed a retrospective cohort study on 78 patients who started palliative chemotherapy at our department from January 2004 to June 2006 due to advanced adenocarcinoma of the pancreas. 46 patients who progressed following first-line therapy were analyzed. Results: In multivariate analyses, time to first progression (TTP1) < 6 months and elevated LDH at the time of diagnosis were shown to be strong and highly significant independent prognostic factors for TTP2 and residual survival. For patients with TTP1 < 6 months, prognosis was poor with a median residual survival of 4.4 versus 7.5 months for those with TTP1 >= 6 months. Conclusion: In our cohort of patients with advanced pancreatic cancer treated with second-line chemotherapy, TTP1 < 6 months is a strong negative prognostic factor for TTP2 and residual survival. Copyright c 2008 S. Karger AG, Basel.