Abstract 184P
Background
Pancreatic cancer remains a highly lethal malignancy with limited treatment options for metastatic and recurrent cases. Nanoliposomal-irinotecan and fluorouracil with leucovorin (NFF) has emerged as the standard treatment following gemcitabine-based regimens. However, the relationship between treatment outcomes and neutropenia in pancreatic cancer has not been thoroughly investigated.
Methods
In this retrospective study, we analyzed data from 161 patients with pancreatic cancer treated with NFF. Neutropenia was assessed based on the Common Terminology Criteria for Adverse Events (CTCAE) cutoffs: Cutoff A (CTCAE Grade 0 versus Grade 1–4), Cutoff B (Grade 0–1 versus Grade 2–4), and Cutoff C (Grade 0–2 versus Grade 3–4). The primary endpoint was overall survival (OS), while secondary endpoints included response rate (RR), progression-free survival (PFS), and relative dose intensity (RDI).
Results
Among the 161 patients, 93/8/22/30/8 had Grade 0/1/2/3/4 neutropenia, respectively. Baseline patient characteristics, including white blood cell (WBC) count, neutrophil count, lymphocyte count, C-reactive protein (CRP) levels, and FU RDI, exhibited significant differences (p<0.05) between two groups separated by Cutoff A and Cutoff B. Additionally, WBC count, neutrophil count, and FU RDI differed significantly (p<0.05) at Cutoff C. Fisher’s exact test revealed significant differences (p<0.05) in RR at Cutoff C, with the odds ratio of Cutoff C being the greatest, followed by Cutoff B and A. Regarding OS, there were significant differences at Cutoff A (hazard ratio (HR), 0.65; 95% CI, 0.44–0.94; p<0.05) and Cutoff B (HR, 0.63; 95% CI, 0.43–0.92; p<0.05), but not at Cutoff C (HR, 0.73; 95% CI, 0.47–1.14; p=0.16). Furthermore, there were significant differences in PFS at Cutoff A and B (p<0.05). Cox regression analysis indicated that neutropenia was significantly associated with OS at Cutoff A and B (adjusted p<0.05).
Conclusions
NFF-induced neutropenia exhibits significant potential as both a predictive factor for treatment response and a prognostic factor for OS in patients with pancreatic cancer.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
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