Prognostic and predictive markers of response to treatment in patients with locally advanced unresectable and metastatic pancreatic adenocarcinoma treated with gemcitabine/nab-paclitaxel: Results of a retrospective analysis
Ana Fernández Montes1, Paula González Villarroel2, Manuel Valladares Ayerbes1, Juan De la Cámara Gómez3, Guillermo Quintero Aldana4, Lidia Vázquez Tuñas5, Mercedes Salgado Fernández1, Mónica Jorge Fernández2, on behalf of the GITuD Group6
1 Departament of Medical Oncology, Complexo Hospitalario Universitario de Ourense, Ourense, Spain
2 Departament of Medical Oncology, Complexo Hospitalario Universitario de Vigo, Pontevedra, Spain
3 Departament of Medical Oncology, Complexo Hospitalario Universitario de Ferrol, Ferrol, A Coruña, Spain
4 Departament of Medical Oncology, Hospital Lucus Augusti, Lugo, spain
5 Departament of Medical Oncology. Hospital de Pontevedra, Pontevedra, Spain
Ana Fernández Montes,
Department of Medical Oncology, Complexo Hospitalario Universitario de Ourense, Servicio de Oncología Médica, E-32005 Ourense
Source of Support: None, Conflict of Interest: None
Background: Recent studies support the use of gemcitabine and nab-paclitaxel in adults with locally advanced unresectable or metastatic pancreatic adenocarcinoma although insufficient data are available on prognostic and predictive markers of response to treatment.
Objective: The objective of this study is to identify treatment response markers in patients with locally advanced unresectable or metastatic pancreatic adenocarcinoma.
Materials and Methods: This is an observational, retrospective, and multicenter study. Sociodemographic, clinical, and therapeutic data were collected. Cox regression models were applied to determine associations.
Results: In total, 39 patients were included; 23.1% presented locally advanced pancreatic cancer and 76.9% metastatic disease. They received a mean of 6 ± 3 treatment cycles; 59% required dose reduction, 59% treatment delay, and 20.5% switched to a biweekly regimen. The overall response rate was 23% and the disease control rate was 81%. Median progression-free survival was 9 months and median overall survival (OS) was 15 months. A higher neutrophil/lymphocyte ratio (NLR) was significantly associated with lower OS. We reported Grades 1–4 nonhematological and hematological toxicities.
Conclusion: NLR is a useful prognostic factor for OS in patients with locally advanced unresectable or metastatic pancreatic adenocarcinoma treated with gemcitabine and nab-paclitaxel. Moreover, we suggest that a biweekly regimen is an option for certain groups of patients.