Efficacy of chemotherapy for patients with metastatic or recurrent pancreatic adenosquamous carcinoma: A multicenter retrospective analysis.

Humans Retrospective Studies Carcinoma, Adenosquamous / drug therapy Pancreatic Neoplasms / drug therapy Carcinoma, Pancreatic Ductal Pancreatic Neoplasms
FOLFIRINOX Gemcitabine Nab-paclitaxel Pancreatic adenosquamous carcinoma Pancreatic cancer

Journal

Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]
ISSN: 1424-3911
Titre abrégé: Pancreatology
Pays: Switzerland
ID NLM: 100966936

Informations de publication

Date de publication:
Dec 2022
Historique:
received: 17 04 2022
revised: 22 08 2022
accepted: 05 09 2022
pubmed: 24 9 2022
medline: 7 12 2022
entrez: 23 9 2022
Statut: ppublish

Résumé

Pancreatic adenosquamous carcinoma (PASC) is a rare variant of pancreatic ductal adenocarcinoma (PDAC). The usual treatment for metastatic or recurrent PASC is systemic chemotherapy in accordance with the PDAC treatment strategy. This study aimed to investigate the efficacy of chemotherapy, especially the benefit of recent combination therapies, in patients with metastatic or recurrent PASC. We conducted a multicenter retrospective analysis of 116 patients with metastatic or recurrent PASC treated with first-line chemotherapy between April 2001 and December 2017 at 24 Japanese institutions. Combination chemotherapies included gemcitabine + nab-paclitaxel (GnP, n = 28), fluorouracil/leucovorin + irinotecan + oxaliplatin (FFX, n = 10), gemcitabine + S-1 (GS, n = 10), and others (n = 9). Monotherapies included gemcitabine (n = 51) and S-1 (n = 8). The median overall survival (OS) was 6.5, 7.3, and 4.3 months for the whole cohort, the combination therapy group, and the monotherapy group, respectively. Multivariate analysis indicated that combination therapy showed a better trend in OS than monotherapy (hazard ratio = 0.68; 95% confidence interval, 0.38-1.20). GnP or FFX were selected in 58.7% of patients after FFX was approved in Japan, and revealed a median OS, median progression-free survival, and objective response rate of 7.3 months, 2.8 months, and 26.9% in GnP and 7.2 months, 2.3 months, and 20.0% in FFX respectively. This study suggests that combination therapy may be more effective than monotherapy. GnP and FFX showed similar and clinically meaningful efficacy for patients with metastatic or recurrent PASC.

Sections du résumé

BACKGROUND/OBJECTIVES OBJECTIVE
Pancreatic adenosquamous carcinoma (PASC) is a rare variant of pancreatic ductal adenocarcinoma (PDAC). The usual treatment for metastatic or recurrent PASC is systemic chemotherapy in accordance with the PDAC treatment strategy. This study aimed to investigate the efficacy of chemotherapy, especially the benefit of recent combination therapies, in patients with metastatic or recurrent PASC.
METHODS METHODS
We conducted a multicenter retrospective analysis of 116 patients with metastatic or recurrent PASC treated with first-line chemotherapy between April 2001 and December 2017 at 24 Japanese institutions.
RESULTS RESULTS
Combination chemotherapies included gemcitabine + nab-paclitaxel (GnP, n = 28), fluorouracil/leucovorin + irinotecan + oxaliplatin (FFX, n = 10), gemcitabine + S-1 (GS, n = 10), and others (n = 9). Monotherapies included gemcitabine (n = 51) and S-1 (n = 8). The median overall survival (OS) was 6.5, 7.3, and 4.3 months for the whole cohort, the combination therapy group, and the monotherapy group, respectively. Multivariate analysis indicated that combination therapy showed a better trend in OS than monotherapy (hazard ratio = 0.68; 95% confidence interval, 0.38-1.20). GnP or FFX were selected in 58.7% of patients after FFX was approved in Japan, and revealed a median OS, median progression-free survival, and objective response rate of 7.3 months, 2.8 months, and 26.9% in GnP and 7.2 months, 2.3 months, and 20.0% in FFX respectively.
CONCLUSIONS CONCLUSIONS
This study suggests that combination therapy may be more effective than monotherapy. GnP and FFX showed similar and clinically meaningful efficacy for patients with metastatic or recurrent PASC.

Identifiants

DOI: 10.1016/j.pan.2022.09.236 PMID: 36150984
pubmed: 36150984
pii: S1424-3903(22)00740-2
doi: 10.1016/j.pan.2022.09.236
pii:
doi:

Types de publication

Multicenter Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1159-1166

Informations de copyright

Copyright © 2022 IAP and EPC. Published by Elsevier B.V. All rights reserved.

Auteurs

Yukio Yoshida (Y)

Division of Oncology and Hematology, Okinawa Chubu Hospital, Okinawa, Japan. Electronic address: yoshida_yukio@hosp.pref.okinawa.jp.

Satoshi Kobayashi (S)

Department of Gastroenterology, Kanagawa Cancer Center, Yokohama, Japan.

Makoto Ueno (M)

Department of Gastroenterology, Kanagawa Cancer Center, Yokohama, Japan.

Chigusa Morizane (C)

Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan.

Kunihiro Tsuji (K)

Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan.

Yuta Maruki (Y)

Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan.

Keita Mori (K)

Department of Biostatistics, Clinical Research Support Center, Shizuoka Cancer Center, Shizuoka, Japan.

Kazuo Watanabe (K)

Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Japan.

Akihiro Ohba (A)

Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan.

Mitsuhiro Furuta (M)

Department of Gastroenterology, Kanagawa Cancer Center, Yokohama, Japan; Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Japan.

Akiko Todaka (A)

Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Japan.

Akiko Tsujimoto (A)

Division of Gastroenterology, Chiba Cancer Center, Chiba, Japan.

Masato Ozaka (M)

Hepato-Biliary-Pancreatic Medicine Department, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.

Naohiro Okano (N)

Department of Medical Oncology, Kyorin University Faculty of Medicine, Tokyo, Japan.

Kei Yane (K)

Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan.

Kumiko Umemoto (K)

Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, Japan.

Yasuyuki Kawamoto (Y)

Division of Cancer Center, Hokkaido University Hospital, Sapporo, Japan.

Takeshi Terashima (T)

Department of Gastroenterology, Kanazawa University, Kanazawa, Japan.

Hidetaka Tsumura (H)

Department of Gastroenterological Oncology, Hyogo Cancer Center, Hyogo, Japan.

Keitaro Doi (K)

Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Kazuhiko Shioji (K)

Department of Internal Medicine, Niigata Cancer Center Hospital, Niigata, Japan.

Akinori Asagi (A)

Department of Gastrointestinal Medical Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan.

Yasushi Kojima (Y)

Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan.

Eiichiro Suzuki (E)

Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan.

Reishi Toshiyama (R)

Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan.

Masayuki Furukawa (M)

Department of Hepato-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan.

Atsushi Naganuma (A)

Department of Gastroenterology, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan.

Rei Suzuki (R)

Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima, Japan.

Haruo Miwa (H)

Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan.

Masafumi Ikeda (M)

Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Japan.

Junji Furuse (J)

Department of Gastroenterology, Kanagawa Cancer Center, Yokohama, Japan; Department of Medical Oncology, Kyorin University Faculty of Medicine, Tokyo, Japan.

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Classifications MeSH

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questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Efficacy of chemotherapy for patients with...
questionsmedicales.fr › Tumeurs › Tumeurs par type histologique › Tumeurs épithéliales épidermoïdes et glandulaires › Carcinomes › Carcinome adénosquameux › Efficacy of chemotherapy for patients with...
questionsmedicales.fr › Maladies endocriniennes › Tumeurs des glandes endocrines › Tumeurs du pancréas › Efficacy of chemotherapy for patients with...
questionsmedicales.fr › Maladies endocriniennes › Tumeurs des glandes endocrines › Tumeurs du pancréas › Carcinome du canal pancréatique › Efficacy of chemotherapy for patients with...
questionsmedicales.fr › Maladies endocriniennes › Tumeurs des glandes endocrines › Tumeurs du pancréas › Efficacy of chemotherapy for patients with...