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
Presenter Tatsunori Shimoi
Authors T. Shimoi1, E. Sasaki2, M. Kudo1, T. Shimoyama1, Y. Omuro1, R. Okamoto1, Y. Maeda1, T. Sasaki1
  • 1Chemotherapy, Cancer and Infectious diseases center Komagome hospital, 113-0021 - Bunkyo-ku, Tokyo/JP
  • 2Cancer and Infectious diseases center Komagome hospital, 113-0021 - Bunkyo-ku, Tokyo/JP

Abstract

Introduction

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.