دورية أكاديمية
أعرض في EDS

Predictors and benefits of multiagent chemotherapy for pancreatic adenocarcinoma: Timing matters.

التفاصيل البيبلوغرافية
العنوان: Predictors and benefits of multiagent chemotherapy for pancreatic adenocarcinoma: Timing matters.
المؤلفون: Valdera FA; Department of Surgery, Brooke Army Medical Center, Ft. Sam Houston, Texas, USA., O'Shea AE; Department of Surgery, Brooke Army Medical Center, Ft. Sam Houston, Texas, USA., Smolinsky TR; Department of Surgery, Brooke Army Medical Center, Ft. Sam Houston, Texas, USA., Carpenter EL; Department of Surgery, Brooke Army Medical Center, Ft. Sam Houston, Texas, USA., Adams AA; Department of Surgery, Brooke Army Medical Center, Ft. Sam Houston, Texas, USA., McCarthy PM; Department of Surgery, Brooke Army Medical Center, Ft. Sam Houston, Texas, USA., Tiwari A; Department of Surgery, University of Texas San Antonio Health Science Center, San Antonio, Texas, USA., Chick RC; Department of Surgery, Brooke Army Medical Center, Ft. Sam Houston, Texas, USA., Kemp-Bohan PM; Department of Surgery, Brooke Army Medical Center, Ft. Sam Houston, Texas, USA., Van Decar S; Department of Surgery, Brooke Army Medical Center, Ft. Sam Houston, Texas, USA., Thomas KK; Department of Surgery, Brooke Army Medical Center, Ft. Sam Houston, Texas, USA., Bader JO; Cancer Insight, LLC, San Antonio, Texas, USA., Peoples GE; Cancer Insight, LLC, San Antonio, Texas, USA., Clifton GT; Department of Surgery, Brooke Army Medical Center, Ft. Sam Houston, Texas, USA., Stojadinovic A; Cancer Insight, LLC, San Antonio, Texas, USA., Nelson DW; Department of Surgery, William Beaumont Army Medical Center, El Paso, Texas, USA., Vreeland TJ; Department of Surgery, Brooke Army Medical Center, Ft. Sam Houston, Texas, USA.
المصدر: Journal of surgical oncology [J Surg Oncol] 2024 Feb; Vol. 129 (2), pp. 244-253. Date of Electronic Publication: 2023 Oct 06.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Wiley-Liss Country of Publication: United States NLM ID: 0222643 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1096-9098 (Electronic) Linking ISSN: 00224790 NLM ISO Abbreviation: J Surg Oncol Subsets: MEDLINE
أسماء مطبوعة: Publication: <2005-> : Hoboken, NJ : Wiley-Liss
Original Publication: New York, Plenum.
مواضيع طبية MeSH: Pancreatic Neoplasms*/drug therapy , Pancreatic Neoplasms*/surgery , Pancreatic Neoplasms*/pathology , Adenocarcinoma*/pathology, Humans ; Chemotherapy, Adjuvant ; Neoadjuvant Therapy ; Proportional Hazards Models ; Retrospective Studies
مستخلص: Introduction: Adjuvant (A) multiagent chemotherapy (MC) is the standard of care for patients with pancreatic adenocarcinoma (PDAC). Tolerating MC following a morbid operation may be difficult, thus neoadjuvant (NA) treatment is preferable. This study examined how the timing of chemotherapy was related to the regimen given and ultimately the overall survival (OS).
Methods: The National Cancer Database was queried from 2006 to 2017 for nonmetastatic PDAC patients who underwent surgical resection and received MC or single-agent chemotherapy (SC) pre- or postresection. Predictors of receiving MC were determined using multivariable logistic regression. Five-year OS was evaluated using the Kaplan-Meier and Cox proportional hazards model.
Results: A total of 12,440 patients (NA SC, n = 663; NA MC, n = 2313; A SC, n = 6152; A MC, n = 3312) were included. MC utilization increased from 2006-2010 to 2011-2017 (33.1%-49.7%; odds ratio [OR]: 0.59; p < 0.001). Younger age, fewer comorbidities, higher clinical stage, and larger tumor size were all associated with receipt of MC (all p < 0.001), but NA treatment was the greatest predictor (OR 5.18; 95% confidence interval [CI]: 4.63-5.80; p < 0.001). MC was associated with increased median 5-year OS (26.0 vs. 23.9 months; hazard ratio [HR]: 0.92; 95% CI: 0.88-0.96) and NA MC was associated with the highest survival (28.2 months) compared to NA SC (23.3 months), A SC (24.0 months), and A MC (24.6 months; p < 0.001).
Conclusion: Use and timing of MC contribute to OS in PDAC with an improved 5-year OS compared to SC. The greatest predictor of receiving MC was being given as NA therapy and the greatest survival benefit was the NA MC subgroup. Randomized studies evaluating the timing of effective MC in PDAC are needed.
(© 2023 Wiley Periodicals LLC.)
References: Pancreatic Cancer Action Network. Pancreatic Cancer Survival Rates. PanCAN; 2021. https://www.pancan.org/facing-pancreatic-cancer/about-pancreatic-cancer/survival-rate/#rate.
Oettle H, Neuhaus P, Hochhaus A, et al. Adjuvant chemotherapy with gemcitabine and long-term outcomes among patients with resected pancreatic cancer: the CONKO-001 randomized trial. JAMA. 2013;310(14):1473-1481.
Neoptolemos JP, Moore MJ, Cox TF, et al. Effect of adjuvant chemotherapy with fluorouracil plus folinic acid or gemcitabine vs observation on survival in patients with resected periampullary adenocarcinoma: the ESPAC-3 periampullary cancer randomized trial. JAMA. 2012;308(2):147-156.
Neoptolemos JP, Palmer DH, Ghaneh P, et al. Comparison of adjuvant gemcitabine and capecitabine with gemcitabine monotherapy in patients with resected pancreatic cancer (ESPAC-4): a multicentre, open-label, randomised, phase 3 trial. The Lancet. 2017;389(10073):1011-1024.
Conroy T, Hammel P, Hebbar M, et al. FOLFIRINOX or gemcitabine as adjuvant therapy for pancreatic cancer. N Engl J Med. 2018;379(25):2395-2406.
Conroy T, Desseigne F, Ychou M, et al. FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med. 2011;364(19):1817-1825.
Von Hoff DD, Ervin T, Arena FP, et al. Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine. N Engl J Med. 2013;369(18):1691-1703.
Tempero MA, Reni M, Riess H, et al. APACT: phase III, multicenter, international, open-label, randomized trial of adjuvant nab-paclitaxel plus gemcitabine (nab-P/G) vs gemcitabine (G) for surgically resected pancreatic adenocarcinoma. J Clin Oncol. 2019;37(15_suppl):4000.
Gemenetzis G, Groot VP, Blair AB, et al. Survival in locally advanced pancreatic cancer after neoadjuvant therapy and surgical resection. Ann Surg. 2019;270(2):340-347.
National Comprehensive Cancer Network.Pancreatic Adenocarcinoma (Version 2), 2021. https://www.nccn.org/professionals/physician&#95;gls/pdf/pancreatic.pdf.
Spitz FR, Abbruzzese JL, Lee JE, et al. Preoperative and postoperative chemoradiation strategies in patients treated with pancreaticoduodenectomy for adenocarcinoma of the pancreas. J Clin Oncol. 1997;15(3):928-937.
Herrmann R, Bodoky G, Ruhstaller T, et al. Gemcitabine plus capecitabine compared with gemcitabine alone in advanced pancreatic cancer: a randomized, multicenter, phase III trial of the Swiss Group for Clinical Cancer Research and the Central European Cooperative Oncology Group. J Clin Oncol. 2007;25(16):2212-2217.
Ghaneh P, Palmer DH, Cicconi S, et al. ESPAC-5F: four-arm, prospective, multicenter, international randomized phase II trial of immediate surgery compared with neoadjuvant gemcitabine plus capecitabine (GEMCAP) or FOLFIRINOX or chemoradiotherapy (CRT) in patients with borderline resectable pancreatic cancer. J Clin Oncol. 2020;38(15_suppl):4505.
Altman AM, Wirth K, Marmor S, et al. Completion of adjuvant chemotherapy after upfront surgical resection for pancreatic cancer is uncommon yet associated with improved survival. Ann Surg Oncol. 2019;26(12):4108-4116.
Abraham A, Al-Refaie WB, Parsons HM, Dudeja V, Vickers SM, Habermann EB. Disparities in pancreas cancer care. Ann Surg Oncol. 2013;20(6):2078-2087.
Dreyer MS, Nattinger AB, McGinley EL, Pezzin LE. Socioeconomic status and breast cancer treatment. Breast Cancer Res Treat. 2018;167(1):1-8.
Lee RM, Liu Y, Gamboa AC, et al. Race, ethnicity, and socioeconomic factors in cholangiocarcinoma: what is driving disparities in receipt of treatment? J Surg Oncol. 2019;120(4):611-623.
Pignon F, Turpin A, Hentic O, et al. Efficacy and tolerance of gemcitabine and nab-paclitaxel in elderly patients with advanced pancreatic ductal adenocarcinoma. Pancreatology. 2021;21:1064-1070.
Tzeng CWD, Katz MHG, Fleming JB, et al. Morbidity and mortality after pancreaticoduodenectomy in patients with borderline resectable type C clinical classification. J Gastrointest Surg. 2014;18(1):146-156.
فهرسة مساهمة: Keywords: chemotherapy; neoadjuvant; pancreatic adenocarcinoma
تواريخ الأحداث: Date Created: 20231006 Date Completed: 20240110 Latest Revision: 20240110
رمز التحديث: 20240110
DOI: 10.1002/jso.27466
PMID: 37800378
قاعدة البيانات: MEDLINE
الوصف
تدمد:1096-9098
DOI:10.1002/jso.27466