Exploring chemotherapy holiday and drugs re-challenge in advanced pancreatic cancer patients
- PDF / 761,672 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 20 Downloads / 186 Views
ORIGINAL ARTICLE
Exploring chemotherapy holiday and drugs re‑challenge in advanced pancreatic cancer patients Marina Macchini1,2 · Umberto Peretti1,2 · Giulia Orsi1,2 · Silvia Zanon1 · Elena Mazza1 · Maria Maddalena Valente1,2 · Domenico Tamburrino2,3 · Giulio Belfiori2,3 · Gemma Rossi2,4 · Sabrina Gloria Giulia Testoni2,4 · Paolo Passoni5 · Claudio Doglioni2,6 · Stefano Cascinu1,2 · Michele Reni1,2 Received: 24 June 2020 / Accepted: 20 October 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose We aimed to explore the role of drugs re-challenge at the disease progression after a chemotherapy-free interval for pancreatic adenocarcinoma (PDAC) patients. Methods We retrospectively analyzed the outcome of re-treatments at the progression in two cohorts of advanced PDAC patients who had disease control (DC) and a treatment holiday ≥ 3 months after upfront chemotherapy. Results Between 2015 and 2019, 66 advanced PDAC patients (cohort A) had DC with nab-paclitaxel-based chemotherapy (i.e. AG or PAXG = cisplatin, nab-paclitaxel, gemcitabine, capecitabine). At the time of progressive disease (PD), 34 patients were re-treated with AG (A1) and 32 were treated with other regimens (A2). The median (m) duration of chemotherapy holiday was 6.1 and 5.9 months in A1 and A2, respectively. Partial response (PR) and stable disease (SD) were found in 14 (41%) and 12 (35%) of patients in A1 and in 8 (25%) and 6 (19%) patients in A2. CA19-9 response was recorded in 23/33 evaluable patients (70%) in A1 and in 5/20 (25%) in A2. mPFS2 and mOS2, defined as the time between the second line of treatment start and the disease progression or death, were 4.8 and 12.2 months in A1 and 3.9 and 8.4 months in A2, respectively. Similarly, between 2006 and 2013, 64 patients (cohort B) had DC with upfront PEFG/PEXG/PDXG regimens (epirubicin or docetaxel, cisplatin, gemcitabine, capecitabine or 5-fluorouracil) and were re-treated at PD with either 4-drug (B1; N = 30) or other regimens (B2; N = 34), yielding a mOS2 of 10.9 and 7.2 months, respectively. Conclusion Our data endorse the strategy of resuming prior drugs after a chemotherapy holiday ≥ 3 months in advanced PDAC patients who achieved a durable disease control after upfront treatments. Keywords Pancreatic cancer · Chemotherapy holiday · Nab-paclitaxel · Re-challenge
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00280-020-04190-1) contains supplementary material, which is available to authorized users. * Michele Reni [email protected] 1
Department of Medical Oncology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy
2
Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute, Milan, Italy
3
Pancreatic Surgery Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
Pancreatic adenocarcinoma (PDAC) is a highly primary chemo-resistant disease with dismal prognosis and few therapeutic options. About 80% of patients w
Data Loading...
