710P - Clinical outcome of elderly (>70y) advanced pancreatic cancer patients receiving chemotherapy

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anti-Cancer Agents & Biologic Therapy
Geriatric Oncology
Pancreatic Cancer
Presenter Andrea Lanese
Citation Annals of Oncology (2014) 25 (suppl_4): iv210-iv253. 10.1093/annonc/mdu334
Authors A. Lanese1, A. Bittoni1, M. Santoni1, K. Andrikou1, C. Pellei1, A. Conti1, P. Bertocchi2, A. Brunetti3, M. Russano4, V. Vaccaro5, N. Silvestris3, M. Milella6, D. Santini7, A. Zaniboni8, S. Cascinu9
  • 1Clinica Di Oncologia Medica, AOU Ospedali Riuniti Ancona Università Politecnica delle Marche, 60126 - Ancona/IT
  • 2Oncologia Medica, Fondazione Poliambulanza, Brescia/IT
  • 3Medical Oncology Unit, National Cancer Institute "Giovanni Paolo II", 70124 - bari/IT
  • 4Medical Oncology, Campus Bio-Medico di Roma, 00128 - Roma/IT
  • 5Medical Oncology, Regina Elena National Cancer Institute, 00144 - Roma/IT
  • 6Divisione Di Oncologia Medica A, Regina Elena National Cancer Institute, 00144 - Roma/IT
  • 7Medical Oncology, Campus Bio-Medico University, 00128 - Rome/IT
  • 8Oncology Department, Fondazione Poliambulanza, IT-25124 - Brescia/IT
  • 9Dipartimento Di Medicina Clinica E Biotecnologie A, AOU Ospedali Riuniti Ancona Università Politecnica delle Marche, 60126 - Ancona/IT

Abstract

Aim

Pancreatic cancer is a disease seen predominantly in elderly patients (pts). However, no standards of care exist for >70y patients. We aimed at evaluating the outcome of elderly pts treated with chemotherapy for pancreatic cancer and the presence of prognostic factors in this subpopulation.

Methods

We reviewed the clinical records of patients with PDAC aged ≥70y treated with chemotherapy in four Italian Oncology Units from January 2005 to April 2014. Survival estimates were quantified using Kaplan Meier curves. Tumor stage, ECOG-Performance Status (PS), pre-treatment CEA and CA 19-9, hemoglobin (Hb), neutrophil, lymphocyte and platelet count as well as LDH were included in the Cox analysis to investigate their prognostic significance.

Results

178 pts were included in this analysis. Median age was 74 years (range 70-88); 97 pts (54.5%) were males; 128 pts (71.9%) had metastatic disease. Median overall survival (OS) was 5.6 months. Median first-line PFS was 3.2 months. Folfirinox was the first-line in 10 pts (5.6%); 90 pts (50.6%) were treated with gemcitabine alone, 78 pts (43.8%) gemcitabine-based doublets, without differences in terms of OS (p = 0.07). Forty-five pts (25.2%) were treated with second-line chemotherapy; median OS of 4.2 months and a PFS of 2.2 months No differences in terms of OS and PFS were found between mono (23 pts) vs combined (22 pts) second-line chemotherapy (p = 0.42). Only 7 pts (3.9%) underwent third-line chemotherapy, with an OS of 8.1 months and a PFS of 1.7 months. At multivariate analysis, ECOG-PS ≥ 2 (p = 0.004) and lymphocyte count (p = 0.04) were independent prognostic factors for OS. Furthermore, ECOG-PS ≥ 2 (p = 0.04), Hb (p = 0.03), lymphocyte (p = 0.01) and neutrophil counts (p = 0.04) were significantly associated with PFS.

Conclusions

Chemotherapy appears to have a similar activity in elderly patients as compared to younger patients with pancreatic cancer. However, combined chemotherapy does not occur to be more effective than monotherapy.

Disclosure

All authors have declared no conflicts of interest.