Pancreatic cancer: standard combination therapy best for recurrence

  • Gbolahan OB & al.
  • BMC Cancer
  • 17 May 2019

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Standard combination chemotherapy (gemcitabine+nab-paclitaxel or FOLFIRINOX) offers significantly better survival than nonstandard combinations (e.g., FOLFOX) or single-agent chemotherapy for recurrent pancreatic ductal adenocarcinoma (rPDAC).

Why this matters

  • Findings support standard combination chemotherapy as the most efficacious chemotherapy option for rPDAC.

Study design

  • Retrospective cohort of 223 patients with rPDAC in the Indiana University database (2008-2014).
  • Funding: None.

Key results

  • Of the 223 patients, 140 received chemotherapy, 71 did not receive chemotherapy, and 12 patients had missing data.
  • Of the 140 patients who received chemotherapy, 53% received any standard combination, 34% received nonstandard combinations, and 13% received single-agent therapy:
    • Any standard combination therapy yielded longer median OS (14 months; 95% CI, 9-17 months) vs 8 months with either nonstandard combinations (95% CI, 5-12 months) or single-agent therapy (95% CI, 6-12 months; P=.029).
  • Multivariate cox regression of the entire cohort (n=223) found that median OS with:
    • Standard combination chemotherapy was superior to single-agent therapy (HR, 0.54; P=.0246).
    • Nonstandard combination chemotherapy was not superior to single-agent therapy (HR, 0.82; P=.4764).
    • Use of any chemotherapy was superior to no chemotherapy (HR, 0.31; P<.0001>

Limitations

  • Single-center, observational, retrospective design.

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