Prognostic impact of progression type by RECIST criteria in patients with metastatic pancreatic cancer who received 1st line gemcitabine based chem...

Date 24 November 2018
Event ESMO Asia 2018 Congress
Session Poster display - Cocktail
Topics Pancreatic Cancer
Presenter Jinsoo Lee
Citation Annals of Oncology (2018) 29 (suppl_9): ix46-ix66. 10.1093/annonc/mdy432
Authors J. Lee, M.A. Lee, I. Kim
  • Department Of Internal Medicine, Division Of Medical Oncology, Seoul St. Mary's Hospital, of the Catholic University, 137-701 - Seoul/KR

Abstract

Background

The appearance of new lesions and increment in size of target lesions are both considered progressive disease in RECIST 1.1. There had been some previous studies that showed the progression with new lesions rather than without new lesions had more negative impact on overall survival in breast cancer and advanced gastric cancer. We aimed to investigate the such prognostic impact of progression type by RECIST in pancreatic cancer.

Methods

We reviewed a retrospective data of total 228 histologically confirmed metastatic pancreatic adenocarcinoma patients treated with 1st line systemic chemotherapy and who showed progressive disease in response evaluation anytime during 1st line gemcitabine based chemotherapy from 2011 to 2017. Progression with appearance of new lesions (PD with NL) and solely size increase of target lesions without new lesion (PD without NL), the two covariates were tested to verify their effects on overall survival (OS), progression free survival (PFS), and post-progression survival (PPS), using a Kaplan-Meier method. Multivariate analysis were done using Cox proportional hazards regression model to examine prognostic factors for PPS and OS. PPS was defined as period between the date of tumour progression observed after 1st-line chemotherapy and the date of death.

Results

The OS of PD without NL was 8.8 months (95% CI, 7.056-10.544, p = 0.017), while the OS of PD with NL was 6.4 month (95% CI 5.391-7.475). The PPS of each PD without NL group and PD with NL group were 4.4 months (95% CI, 3.571-5.229) and 2.5 months (95% CI, 1.877 -3.057) with p = 0.001. However, there was no statistical difference between PFS of both groups, which were 3.27 months (95%, 2.452-4.082) and 3.600 (95% CI, 2.937-4.263) with p = 0.410. In multivariate analysis of prognostic factors for overall survival, number of metastatic sites, the 1st line chemotherapy type, and the progression types were statistically significant.

Conclusions

By categorizing progressive disease according to the presence of new lesion and analysing the data, the progression with new lesions rather than without new lesions was more negatively associated patient’s OS and PPS.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

Institutional Review Board of Seoul St. Mary’s Hospital.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.