The Real-Life Efficacy of the Second Line Treatment Strategy in Advanced Pancreas Cancer
Received Date : 09 Feb 2022
Accepted Date : 23 May 2022
Available Online : 06 Jun 2022
Doi: 10.37047/jos.2022-88853 - Article's Language: EN
J Oncol Sci.
Objective: Pancreatic cancer is one of the leading causes of cancer-related death. Despite the introduction of new therapeutic
agents, survival rates remain low. Furthermore, few trials have evaluated the options for second-line therapy and the prognostic variables. In
this study, we aimed to determine the real-world efficacy and prognostic parameters of second-line treatment for advanced pancreatic cancer.
Material and Methods: Patients with advanced pancreatic cancer from different centers who received second-line treatment were enrolled
in the study. The patients’ demographic, clinical, and pathological characteristics were retrieved retrospectively. Results: A total of 161 patients
were enrolled in the study. The majority of the patients (50.3%) received oxaliplatin plus fluoropyrimidine as second-line treatment. The
median progression-free survival and overall survival for the entire cohort were 2.5 months and 4.5 months, respectively. In univariate analyses,
an Eastern Cooperative Oncology Group performance status ≥2, age ≥65 years, hypoalbuminemia, thrombocytosis, presence of metastatic
peritoneal disease, elevated alkaline phosphatase and carcinoembryonic antigen levels, and a neutrophil-lymphocyte ratio (NLR) ≥3 were
identified as poor prognostic factors. In multivariable analyses, low albumin level (p=0.031) and high NLR (p=0.05) were found to be independent
prognostic factors for overall survival. Conclusion: Pancreatic cancer is a unique malignancy, and advanced disease has a dismal prognosis.
In univariate analyses, we identified multiple factors that were poor prognostic variables. In particular, the albumin level and NLR
were independent prognostic factors for overall survival, and these parameters might be useful in selecting the second-line treatment and predicting
the survival of these patients.
Keywords: Chemotherapy; prognostic factors; pancreatic cancer; oxaliplatin, irinotecan