Retrospective analysis of efficacy and safety of Cell-free and Concentrated Ascites Reinfusion Therapy in pancreatic cancer patients with malignant...

Date 24 November 2018
Event ESMO Asia 2018 Congress
Session Poster display - Cocktail
Topics Palliative Care
Pancreatic Cancer
Presenter Kazuaki Harada
Citation Annals of Oncology (2018) 29 (suppl_9): ix109-ix112. 10.1093/annonc/mdy440
Authors K. Harada1, Y. Kobayashi1, S. Nozawa2, K. Sakurai2, K. Suto2, A. Yoshikawa2, R. Sasaki2, R. Abiko2, H. Ebata2, I. Sano2, H. Oda2, T. Miyagishima2
  • 1Department Of Medical Oncology, Kushiro Rosai Hospital, 085-8533 - Kushiro/JP
  • 2Department Of Internal Medicine, Kushiro Rosai Hospital, 085-8533 - Kushiro/JP

Abstract

Background

Cell-free and Concentrated Ascites Reinfusion Therapy (CART) is expected to improve some symptoms related to ascites. However, its efficacy and safety for malignant ascites of pancreatic cancer (PC) patients has not been fully elucidated. The aim of this study is to assess the clinical significance of CART in PC with malignant ascites.

Methods

In this retrospective analysis, we examined 226 CART processes performed on 54 patients with advanced PC from April 2010 to March 2018 in our institution. Adverse events (AE) related to CART and patient’s symptoms were assessed by using CTCAE v4.0. Improvements in ECOG Performance Status (PS) and patient’s symptoms were analyzed using Wilcoxon signed rank test. Survival analyses were performed with Kaplan-Meier method, Log-rank test, and Cox-proportional hazard model.

Results

Patients characteristics were as follows: male/female 32/22, median age 70 (range 41-80), median number of CART 2 (range 1-42), PS (1/2/3/4) 10/22/18/4, primary surgery (Yes/No) 3/51, chemotherapy before CART (Yes/No) 35/19, and chemotherapy after CART (Yes/No) 16/38, respectively. Following initial CART, PS (p = 0.003), anorexia (p < 0.001), and fatigue (p < 0.001) were significantly improved. Three patients with PS3 and two patients with grade3 anorexia could receive chemotherapy along with improvement of their symptom after CART. The median overall survival (OS) was 33.0 days (95% CI; 21.9-44.0). In Cox multivariate analysis, PS had an independent prognostic impact (hazard ratio: 0.354, 95%CI: 0.163-0.771, p = 0.009). Especially for PS0-2 patients after CART (N = 37), receiving chemotherapy was significantly related to better OS (hazard ratio: 0.393, 95%CI: 0.177-0.874, p = 0.022). There were no severe AE related to CART and treatment-related death.

Conclusions

CART was performed safely and was useful to improve some symptoms for PC patients with malignant ascites. Our results suggested CART could be lead to administrate the chemotherapy and may contribute to the improvement of survival in patients with PC.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

Kushiro Rosai Hospital.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.