258P - First-line chemotherapies with FOLFIRINOX or gemcitabine plus nab-paclitaxel for unresectable pancreatic ductal adenocarcinoma in Japanese daily cl...

Date 17 December 2016
Event ESMO Asia 2016 Congress
Session Poster lunch
Topics Anticancer agents
Pancreatic Cancer
Presenter Masaaki Yano
Citation Annals of Oncology (2016) 27 (suppl_9): ix68-ix85. 10.1093/annonc/mdw582
Authors M. Yano1, T. Terashima2, T. Yamashita2, M. Miyazawa3, H. Mizuno4, Y. Nomura5, H. Omura6, Y. Takata7, N. Ooishi2, H. Shugo8, K. Yamada9, H. Takabatake10, H. Takatori11, Y. Hodo12, R. Nishino13, T. Hayashi14, E. Mizukoshi2, S. Kaneko2
  • 1Internal Medicine(gastroenterology), Toyama Prefectural Central Hospital, 930-8550 - Toyama/JP
  • 2Gastroenterology, Kanazawa University Hospital, 920-8641 - Kanazawa/JP
  • 3Gastroenterology, National Hospital Organization Kanazawa Medical Center, 920-8650 - Kanazawa/JP
  • 4Gastroenterology, Toyama City Hospital, 939-8511 - Toyama/JP
  • 5Internal Medcine, FukuiKen Saiseikai Hospital, 918-8503 - Fukui/JP
  • 6Gastroenterology, Ishikawa Prefectural Central Hospital, 920-8530 - Kanazawa/JP
  • 7Gastroenterology, Tonami General Hospital, 939-1395 - Tonami/JP
  • 8Gastroenterology, Municipal Tsuruga Hospital, 914-8502 - Tsuruga/JP
  • 9Gastroenterology, Keiju Medical Center, 926-8605 - Nanao/JP
  • 10Gastroenterology, Japanese Red Cross Kanazawa Hospital, 921-8162 - Kanazawa/JP
  • 11Gastroenterology, Public Central Hospital of Matto-Ishikawa, 924-8588 - Hakusan/JP
  • 12Gastroenterology, Saiseikai Kanazawa Hospital, 920-0353 - Kanazawa/JP
  • 13Internal Medicine, Hakui Public Hospital, 925-8502 - Hakui/JP
  • 14Gastroenterology And General Surgery, Yawata Medical Center, 923-8551 - Komatsu/JP

Abstract

Background

FOLFIRINOX (FFX) and gemcitabine (GEM) plus nab-paclitaxel (GnP) have been available for unresectable pancreatic ductal adenocarcinoma (PDAC) treatment since December 2013 and December 2014, respectively, in Japan. We conducted a multi-center retrospective study to investigate first-line chemotherapies in daily clinical practice for unresectable PDAC over the last 4 years.

Methods

We retrospectively reviewed the medical records of 530 patients diagnosed with unresectable PDAC between August 2012 and July 2015.

Results

The median patient age was 73 years, and 54% were men; the ECOG performance status (PS) was 0 in 50%, 1 in 33%, and 2 or greater in 17%. The patients with primary PDAC were classified as having UICC stage III (20%) or IV disease (69%), and 9% had a postoperative recurrence. A total of 392 patients (74%) were treated with anti-tumor therapies: chemotherapy (87%), chemoradiotherapy (10%), or other (3%); the remaining patients were treated with supportive care. As first-line chemotherapy, among 153 patients diagnosed in 2012 and 2013, 58% were treated with GEM and 20% were treated with S-1; among 114 patients diagnosed in 2014, 47% were treated with GEM, 23% with S-1, and 20% with FFX; and among 75 patients diagnosed in 2015, 31% were treated with FFX, 25% with GnP, and 23% with GEM. The objective response rate based on RECIST v1.1 was 14.8% after treatment with FFX, 36.8% with GnP, and 4.6% with GEM. The median survival was 9.8 months after FFX treatment, 9.5 months after GnP, 6.2 months after GEM, and 2.0 months after best supportive care. Grade 3 or greater neutropenia, anemia, and thrombocytopenia were observed in 64%, 11%, and 9% of the patients treated with FFX; 45%, 25%, and 10% with GnP; and 15%, 7%, and 8% with GEM, respectively. Second-line chemotherapy was conducted in 80% of the patients in the FFX group, 67% in the GnP group, and 43% in the GEM group.

Conclusions

The use of FFX and GnP as first-line chemotherapy for patients with PDAC has recently increased. These two regimens are feasible and improved the anti-tumor effect and patient prognosis in daily clinical practice in Japan.

Clinical trial indentification

Legal entity responsible for the study

Kanazawa University

Funding

Kanazawa University

Disclosure

All authors have declared no conflicts of interest.