Observational Study of Clinical Practice in Patients with Pancreatic Adenocarcinoma in Greece.
Journal
Journal of oncology
ISSN: 1687-8450
Titre abrégé: J Oncol
Pays: Egypt
ID NLM: 101496537
Informations de publication
Date de publication:
2020
2020
Historique:
received:
17
02
2020
revised:
14
08
2020
accepted:
07
09
2020
entrez:
5
10
2020
pubmed:
6
10
2020
medline:
6
10
2020
Statut:
epublish
Résumé
During the last decade, significant improvement was made in systemic therapy of pancreatic adenocarcinoma (PAC). The impact of this progress in everyday clinical practice has not been fully described yet. The aim of the study was to investigate the pattern followed by Greek Medical Oncologists regarding the treatment of patients with PAC. This observational, noninterventional multicenter study recorded clinical data from the files of 200 active patients (alive and under treatment or follow-up) for a two-year period (November 2015 until November 2017) from 20 oncology centers around Greece. In total, 51 (25.5%) patients underwent radical surgical resection of PAC, and 40 (78.4%) of them received adjuvant and 1 (2.0%) neoadjuvant chemotherapy. The median time to recurrence was 7.9 months, and median overall survival (OS), 20.2 months. First-line chemotherapy was administered to 193 (96.5%) patients. The majority of patients were treated with the combination of nab-paclitaxel-gemcitabine (NPG), 5-fluorouracil, leucovorin, irinotecan, oxaliplatin (FOLFIRINOX), or gemcitabine monotherapy. Of them, 39.5% responded to the treatment. Median OS and PFS were 14.1 months and 7.0 months, respectively. Second-line treatment was administered to 112 patients. The majority received NPG, FOLFIRINOX/capecitabine, oxaliplatin, irinotecan (CAPOXIRI), or 5-fluorouracil, leucovorin, oxaliplatin (FOLFOX)/capecitabine, oxaliplatin (CAPOX). Median OS with second-line treatment was 8.6 months, and median PFS, 5.5 months. The most common chemotherapy sequences were NPG as first-line followed by FOLFIRINOX/CAPOXIRI as second-line, NPG followed by FOLFOX/CAPOX, NPG followed by other regimens, and FOLFIRINOX/CAPOXIRI followed by NPG. This study described the significant improvement in prognosis of PAC patients receiving palliative chemotherapy and the relatively high rate of receipt of second-line chemotherapy, according to real-world data. However, due to the nonrandomized nature of the study, any comparison between different chemotherapy regimens should be regarded with caution.
Sections du résumé
BACKGROUND
BACKGROUND
During the last decade, significant improvement was made in systemic therapy of pancreatic adenocarcinoma (PAC). The impact of this progress in everyday clinical practice has not been fully described yet. The aim of the study was to investigate the pattern followed by Greek Medical Oncologists regarding the treatment of patients with PAC.
METHODS
METHODS
This observational, noninterventional multicenter study recorded clinical data from the files of 200 active patients (alive and under treatment or follow-up) for a two-year period (November 2015 until November 2017) from 20 oncology centers around Greece.
RESULTS
RESULTS
In total, 51 (25.5%) patients underwent radical surgical resection of PAC, and 40 (78.4%) of them received adjuvant and 1 (2.0%) neoadjuvant chemotherapy. The median time to recurrence was 7.9 months, and median overall survival (OS), 20.2 months. First-line chemotherapy was administered to 193 (96.5%) patients. The majority of patients were treated with the combination of nab-paclitaxel-gemcitabine (NPG), 5-fluorouracil, leucovorin, irinotecan, oxaliplatin (FOLFIRINOX), or gemcitabine monotherapy. Of them, 39.5% responded to the treatment. Median OS and PFS were 14.1 months and 7.0 months, respectively. Second-line treatment was administered to 112 patients. The majority received NPG, FOLFIRINOX/capecitabine, oxaliplatin, irinotecan (CAPOXIRI), or 5-fluorouracil, leucovorin, oxaliplatin (FOLFOX)/capecitabine, oxaliplatin (CAPOX). Median OS with second-line treatment was 8.6 months, and median PFS, 5.5 months. The most common chemotherapy sequences were NPG as first-line followed by FOLFIRINOX/CAPOXIRI as second-line, NPG followed by FOLFOX/CAPOX, NPG followed by other regimens, and FOLFIRINOX/CAPOXIRI followed by NPG.
CONCLUSION
CONCLUSIONS
This study described the significant improvement in prognosis of PAC patients receiving palliative chemotherapy and the relatively high rate of receipt of second-line chemotherapy, according to real-world data. However, due to the nonrandomized nature of the study, any comparison between different chemotherapy regimens should be regarded with caution.
Identifiants
pubmed: 33014051
doi: 10.1155/2020/5304516
pmc: PMC7520678
doi:
Types de publication
Journal Article
Langues
eng
Pagination
5304516Informations de copyright
Copyright © 2020 George Papaxoinis et al.
Déclaration de conflit d'intérêts
The authors declare that they have no conflicts of interest.
Références
Cancer Commun (Lond). 2018 Jun 4;38(1):32
pubmed: 29866170
Acta Oncol. 2018 Sep;57(9):1185-1191
pubmed: 29741436
Lancet. 2016 Jul 2;388(10039):73-85
pubmed: 26830752
Pancreas. 2015 Nov;44(8):1259-65
pubmed: 26262591
Int J Cancer. 2018 Dec 15;143(12):3227-3239
pubmed: 29923613
Lancet. 2016 Feb 6;387(10018):545-557
pubmed: 26615328
Sci Rep. 2018 Jun 6;8(1):8666
pubmed: 29875415
N Engl J Med. 2018 Dec 20;379(25):2395-2406
pubmed: 30575490
J Cancer Res Clin Oncol. 2016 Jun;142(6):1353-60
pubmed: 26995276
JAMA. 2007 Jan 17;297(3):267-77
pubmed: 17227978
N Engl J Med. 2013 Oct 31;369(18):1691-703
pubmed: 24131140
Br J Cancer. 2015 Sep 29;113(7):989-95
pubmed: 26372701
Ann Surg Oncol. 2017 Aug;24(8):2387-2396
pubmed: 28534079
J Gastrointest Cancer. 2015 Mar;46(1):9-20
pubmed: 25403828
Lancet. 2017 Mar 11;389(10073):1011-1024
pubmed: 28129987
N Engl J Med. 2011 May 12;364(19):1817-25
pubmed: 21561347
Clin Colorectal Cancer. 2018 Sep;17(3):187-197
pubmed: 29615310
CA Cancer J Clin. 2019 Jan;69(1):7-34
pubmed: 30620402
World J Gastrointest Oncol. 2018 Dec 15;10(12):505-515
pubmed: 30595804
N Engl J Med. 2004 Mar 18;350(12):1200-10
pubmed: 15028824
Cancer. 2017 Dec 1;123(23):4680-4686
pubmed: 28817187
Oncol Lett. 2017 Jun;13(6):4917-4924
pubmed: 28599496
Int J Cancer. 2019 Mar 1;144(5):981-990
pubmed: 30006989
J Clin Med. 2019 May 29;8(6):
pubmed: 31146420
J Clin Oncol. 1997 Jun;15(6):2403-13
pubmed: 9196156
In Vivo. 2018 May-Jun;32(3):653-657
pubmed: 29695574
Acta Oncol. 2015 Mar;54(3):403-10
pubmed: 25263080
Clin Res Hepatol Gastroenterol. 2020 Jun;44(3):295-301
pubmed: 31607641