695P - Does first-line therapy affect the outcome of patients with pancreatic cancer?

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anticancer Agents
Pancreatic Cancer
Biological Therapy
Presenter Matteo Santoni
Citation Annals of Oncology (2014) 25 (suppl_4): iv210-iv253. 10.1093/annonc/mdu334
Authors M. Santoni1, A. Bittoni2, K. Andrikou2, A. Lanese2, C. Pellei1, A. Conti2, P. Bertocchi3, A.E. Brunetti4, M. Russano5, V. Vaccaro6, N. Silvestris7, M. Milella8, D. Santini5, A. Zaniboni9, S. Cascinu1
  • 1Clinica Di Oncologia Medica, AOU Ospedali Riuniti Ancona Università Politecnica delle Marche, 60126 - Ancona/IT
  • 2Clinica Di Oncologia Medica, AOU Ospedali Riuniti Ancona Università Politecnica delle Marche, Ancona/IT
  • 3Oncologia Medica, Fondazione Poliambulanza, Brescia/IT
  • 4Medical Oncology, National Cancer Institute "Giovanni Paolo II", Bari/IT
  • 5Medical Oncology, Campus Bio-Medico di Roma, 00128 - Roma/IT
  • 6Medical Oncology, Regina Elena National Cancer Institute, 00144 - Roma/IT
  • 7Medical Oncology Unit, National Cancer Institute "Giovanni Paolo II", 70124 - bari/IT
  • 8Divisione Di Oncologia Medica A, Istituto Nazionale Tumori Regina Elena, Roma/IT
  • 9Oncology Department, Fondazione Poliambulanza, IT-25124 - Brescia/IT



A variety of cytotoxic agents, either alone or in combination, have been evaluated as first-line chemotherapies for patients (pts) with locally advanced or metastatic pancreatic cancer. However, no standard of care exists. Aim of this study was to evaluate the prognostic significance of different first-line chemotherapies in pts with pancreatic ductal adenocarcinoma (PDAC).


We retrospectively investigated clinical and laboratory data of pts treated with first-line chemotherapy for PDAC between January 2005 and April 2014 in four Italian institutions. Survival estimates were quantified using Kaplan Meier curves. Age, sex, ECOG-Performance Status (PS), tumor stage, pre-treatment CEA and CA 19-9 and first-line chemotherapy were included in the Cox analysis to investigate their prognostic relevance.


479 pts were included in this analysis. Median age was 66 years (range 36-88); 274 pts were males (57%). Median overall survival (OS) was 7.9 months (range 0.3-60.8), while median PFS was 3.4 months (range 0.3-44.2). OS was 4.7, 7.5, 10.7 and 11.7 months in pts treated with gemcitabine (128 pts), gemcitabine and cisplatin/oxaliplatin (216), gemcitabine and capecitabine (39) and Folfirinox (96), respectively (p < 0.001). Similarly, PFS was 2.6, 3.0, 5.8 and 4.9 months (p < 0.001). At multivariate analysis, tumor stage (p < 0.001), ECOG-PS ≥ 2 (p < 0.001) and choice of first-line chemotherapy (p < 0.001) were independent prognostic factors for OS. Furthermore, ECOG-PS ≥ 2 (p = 0.002) and choice of first-line chemotherapy (p < 0.001) were independent predictors of PFS.


Folfirinox regimen showed the highest OS and PFS as compared to gemcitabine alone or in combination with other agents as first-line therapy. The choice of first-line chemotherapy resulted an independent prognostic factor for both OS and PFS of pts with PDAC.


All authors have declared no conflicts of interest.