Prognostic factors in advanced pancreatic ductal adenocarcinoma patients-receiving second-line treatment: a single institution experience

• L. Gutierrez Sainz ^[1] ; D. Viñal ^[1] ; J. Villamayor ^[1] ; D. Martinez Perez ^[1] ; J.A. Garcia Cuesta ^[1] ; I. Ghanem ^[1] ; A. Custodio ^[1] ; J. Feliu ^[1]
  1. [1] Hospital Universitario La Paz

     Hospital Universitario La Paz

     Madrid, España

     
• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 23, Nº. 9, 2021, págs. 1838-1846
• Idioma: inglés
• Enlaces
  • Texto completo
• Resumen

  • Background Second-line (2L) treatments for advanced pancreatic ductal adenocarcinoma (PDAC) achieve a modest benefit at the expense of potential toxicity. In the absence of predictive factors of response, the identification of prognostic factors could help in the therapeutic decisions-making. The purpose of this study was to assess the prognostic factors associated with shorter survival in patients with advanced PDAC who received 2L treatment.

    Methods We conducted a single institution retrospective study, which included all patients with advanced PDAC who received 2L treatment between September 2006 and February 2020 at La Paz University Hospital, Madrid (Spain). Signifi- cant variables in the logistic regression model were used to create a prognostic score.

    Results We included 108 patients. The median overall survival (OS) was 5.10 months (95%CI 4.02–6.17). In the multivariate analysis, time to progression (TTP) shorter than 4 months after first-line treatment (OR 4.53 [95%CI 1.28–16.00] p = 0.01), neutrophil-to-lymphocyte ratio (NLR) greater than 3 at the beginning of 2L (OR 9.07 [95%CI 1.82–45.16] p = 0.01) and CA-19.9 level higher than the upper limit of normal at the beginning of 2L (OR 7.83 [95%CI 1.30–49.97] p = 0.02) were independently associated with OS shorter than 3 months. The prognostic score classified patients into three prognostic groups (good, intermediate and poor) with significant differences in OS (p < 0.001).

    Conclusions TTP shorter than 4 months after first-line treatment, NLR greater than 3 and CA-19.9 level higher than the upper limit of normal at the beginning of 2L were associated with shorter overall survival. We developed a prognostic score that classifies patients with advanced PDAC into three prognostic groups after progression to the first-line. This score could help in the decision-making for 2L treatment.