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• W3042085175 abstract "The appearance of FOLFIRINOX (FFX) and gemcitabine plus nab-PTX (GnP) prolonged the overall survival (OS) of advanced or unresectable pancreatic cancer (AUPC) dramatically. However, the correlation between progression-free survival (PFS) and OS with the two regimens for AUPC cases as first-line chemotherapy (CTx) has been unknown. Also, we have no established data about the correlation between the number of chemotherapeutic key drugs used for AUPC and its OS despite their increase. We, therefore, performed a retrospective study to validate the two correlations in the real world. This retrospective study named NAPOLEON collected the data from CTx-naive AUPC patients treated with FFX or GnP as first-line CTx from 14 hospitals in Japan during the period from December 2013 to June 2018. A total of 318 patients received FFX (118 patients) or GnP (200 patients) as first-line CTx. Censored cases of these being excluded, 238 cases were analyzed. The correlation between PFS and OS was analyzed with M-estimation which was one of the robust estimation methods. Then, hierarchical clustering was performed by Euclidean distance and Ward’s method for standardized PFS and OS, and patient characteristics between two clustered groups eventually were compared. Finally, a scatter plot between the usage rate of chemotherapeutic key drugs (5-FU, gemcitabine, nab-PTX, l-OHP, and CPT-11) administered for patients and median OS was created by use of bootstrap resampling method for all 318 patients. M-estimated correlation coefficient (MCC) and coefficient of determination at robust regression line of PFS and OS were 0.81 and 0.91, respectively. In patients 65 years and over or less than 65 years cases, MCCs were 0.87 and 0.71, respectively, and statistical significance was shown between them (p < 0.01). However, in those 70 years and over or less than 70 years cases, MCCs were 0.81 and 0.81, respectively (p = 0.97). By regimen analysis, the MCC in GnP cases was significantly higher than that in FFX cases (0.84 vs 0.74, p = 0.04). Hierarchical clustering analysis identified two subgroups showing good (cluster A) and poor (cluster B) correlation between PFS and OS. MCCs of cluster A and cluster B were 0.85 and 0.31, respectively (p < 0.01). Related with cluster A, tumor size of cluster B was significantly smaller and C-reactive protein (CRP) level of cluster B was lower, too. In the end, MCC and coefficient of determination at bootstrap scatter plot of the rate of patients used up all key drugs and median OS were 0.085 and 0.010, respectively. PFS is supposed to be a surrogate endpoint of OS in first-line combination CTx for AUPC overall. However, we might need to be careful in treating patients with smaller tumor size and lower CRP levels because of the weak correlation. Also, there exists little correlation between the number of chemotherapeutic key drugs used for AUPC and its OS." @default.
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• W3042085175 date "2020-07-01" @default.
• W3042085175 modified "2023-09-30" @default.
• W3042085175 title "P-88 A multicenter analysis of the correlation between overall survival and progression-free survival and the number of chemotherapeutic key drugs used in patients with advanced/unresectable pancreatic cancer: Results from the NAPOLEON study" @default.
• W3042085175 doi "https://doi.org/10.1016/j.annonc.2020.04.170" @default.
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