P-178 - First-line chemotherapy with gemcitabine in advanced pancreatic cancer: a retrospective single-center analysis

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Anti-Cancer Agents & Biologic Therapy
Pancreatic Cancer
Presenter H. Magalhães
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors H. Magalhães, M. Cassiano Neves, M. Fontes e Sousa, M. Machado, D. Marques, C. Faustino, N. Sousa, P. Ferreira, A. Raimundo, M. Fragoso, M. Luis, C. Sales
  • IPO-Porto, Porto/PT

Abstract

Introduction

Approximately 80% of patients with pancreatic cancer have advanced disease at the time of diagnosis, either locally advanced non resectable disease or metastatic disease. These patients have a poor prognosis, so in this setting, systemic treatment turns out to be standard of care. In 1997, gemcitabine (GEM) in monotherapy became the reference in front-line therapy after a randomized trial showed a relevant clinical benefit and a median overall survival of 5,65 months, when compared with fluorouracil.

Methods

Retrospective analysis of a consecutive series of patients with locally advanced non resectable or metastatic pancreatic cancer, treated with primary chemotherapy with GEM (GEM 1000mg/m2 on days 1,8 and 15 cycles each 28 day cycles, or the standard schedule with an induction of GEM 1000mg/m2, per week for 7 weeks, followed by 1 week of rest and, after, GEM 1000mg/m2 on days 1,8 and 15 cycles each 28 day cycles), from June 2011 until November 2014. The primary endpoint was overall survival. Survival was calculated with Kaplan-Meier method considering the time difference between the date of death or last observation and the date of the first cycle of GEM. Toxicity was classified according to Common Toxicity Criteria of Adverse Event (Version 3).

Results

A total of 46 patients were included with a median age at diagnosis of 70 years (51-85) and most of them were male (67,4%). About 45,7% of the patients presented with metastatic disease and 47,8% with unresectable tumor. The median follow-up time was 18 months. The median overall survival was 8 months (CI 95%: 6,68-9,31months). Hematologic toxicity was the most frequent toxicity: 15,2% patients had neutropenia G3 and 15,2% had thrombocytopenia G2. One patient was admitted for treatment of febrile neutropenia. The rate of death associated with toxic effects or within 30 days of last cycle was 6,5% (3 patients).

Conclusion

Our results are similar to the results of the randomized trial that gave the approval of gemcitabine in advanced disease. In our experience, gemcitabine is well tolerated and it's still one option of treatment for fragile patients with locally advanced non resectable or metastatic pancreatic cancer.