1171P - The impact of performance status at diagnosis on progression-free survival after second-line chemotherapy in unfavorable-risk cancer of unknown prim...
|Date||29 September 2012|
|Event||ESMO Congress 2012|
|Session||Poster presentation I|
|Topics|| Carcinoma of Unknown Primary Site
T. Shimoi1, E. Sasaki2, M. Kudo1, T. Shimoyama1, Y. Omuro1, R. Okamoto1, Y. Maeda1, T. Sasaki1
Cancer of unknown primary (CUP) patients classified as an unfavorable-risk group generally have a poor prognosis. Moreover, there are no well-defined studies of the efficacy of second-line chemotherapy in unfavorable-risk CUP patients. Unfavorable-risk CUP patients who had second-line chemotherapy were retrospectively reviewed, and the characteristics predictive of better progression-free survival (PFS) after second-line chemotherapy were examined.Methods
A total of 117 CUP patients was diagnosed in our hospital between May 2002 and April 2012, and 97 patients had more than first-line chemotherapy. A total of 34 patients (46% of unfavorable-risk patients) received second-line chemotherapy.Results
Among 34 patients, there were 21 female patients (62%). The median age was 60 (range, 39–74) years. The majority of patients had PS 1 (75%). Adenocarcinoma was present in 25 patients. The median number of primary metastatic sites was 2.5 (range, 1–8) sites, with 3 (range, 1–9) metastatic sites before second-line chemotherapy. For the first-line chemotherapy regimen, 28 patients (82%) had a platinum-based combination regimen. For second-line chemotherapy, 12 patients received platinum-based combination chemotherapy, 12 patients had non-platinum-based combination chemotherapy, and 10 patients had non-platinum-based monotherapy. Response to second-line chemotherapy; 7 (21%) patients showed an objective partial response, and 16 (47%) showed stable disease. The median overall survival in 34 unfavorable-risk CUP patients who could receive second-line chemotherapy was 46 months (median survival time not reached). The median PFS after second-line chemotherapy was 1.8 (range, 0.23–25) months. Multivariate Cox analysis showed that PS 0 or 1 relative to PS 2 at initial diagnosis was related to better PFS (Hazard Ratio, 0.033; 95% confidence interval, 0.00053-0.61) (p = 0.022).Conclusion
The results of this retrospective study showed that 21% of unfavorable-risk patients responded to second-line chemotherapy. The data suggest that PS 0 or 1 may be associated with better PFS after second-line chemotherapy.Disclosure
All authors have declared no conflicts of interest.