Abstract 372P
Background
Chemotherapy (CTx) is the standard of care in aPC, but the best management of pts who received ≥ 2 lines of CTx is still to be defined. We aimed to assess if single-CTx provides similar results to combo-CTx based on our tertiary center experience.
Methods
We retrospectively collected data from pts with aPC treated from 2015 to 2024, who received ≥ 1 cycle of 3L CTx. Progression-free survival (PFS) and overall survival (OS) were calculated from the start of 3L therapy until progression, death, or last follow-up. Data were analyzed using log-rank and Cox regression model.
Results
Overall population included 61 pts. Median age was 66 years (range, 51 - 78). 36 pts (59%) were male; 29 (52%) presented with de novo metastatic disease, 32 (48%) with recurrent disease. Most common metastatic sites were liver (45%), peritoneum (17%), distal nodes (16%), lung (12%). All pts progressed to fluoropyrimidine- and gemcitabine-based CTx. 26 pts (43%) received 3L single-CTx: 15 pts (58%) irinotecan, 5 (19%) capecitabine, 4 (15%) gemcitabine, 2 (8%) 5-FU. 35 pts (57%) received 3L combo-CTx: 22 pts (63%) FOLFIRI, 7 (20%) XELOX, 6 (17%) FOLFOX. Median duration of treatment was 2.4 mos (range, 0 – 12.6) vs 1.8 mos (range, 1.4 – 12.4) for single-CTx and combo-CTx (p = 0.3). Objective response rate (all partial responses) was 12% for single-CTx and 6% for combo-CTx. Disease control rate was 24% and 20% for single-CTx and combo-CTx. At a median follow-up of 4.3 mos, median PFS was 3.7 mos (95% CI, 2.9 – 9.5) with single-CTx vs 2.76 mos (95% CI 2.2 – 4.0) with combo-CTx (HR 0.71, 95% CI 0.38 - 1.32; p = 0.2). Median OS was 5.3 mos (95% CI 4.0 - 6.5) with single-CTx vs 6.2 mos (95% CI 4.0 - 7.9) with combo-CTx (HR 1.03, 95% CI 0.58 – 1.83; p = 0.9).
Conclusions
There was no statistically significant difference in efficacy outcomes between single-CTx and combo-CTx. As a result, a careful choice for a less aggressive 3L CTx regimen may be feasible, potentially sparing toxicity, without losing efficacy. However, our experience may be biased by the small sample size, and more research including quality-of-life assessment is needed.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
R. Balsano: Financial Interests, Personal, Other, Lecture fees: AstraZeneca; Financial Interests, Personal, Other, Travel expenses: Roche. T. Pressiani: Financial Interests, Personal, Other, Consulting fees: Bayer, Ipsen, AstraZeneca; Financial Interests, Institutional, Other, Research funding: Roche, Bayer, AstraZeneca; Financial Interests, Personal, Other, Travel expenses: Roche. L. Rimassa: Financial Interests, Personal, Other, Consulting fees: AbbVie, AstraZeneca, Basilea, Bayer, Elevar Therapeutics, Exelixis, Genenta, Hengrui, Incyte, Ipsen, IQVIA, Jazz Pharmaceuticals, MSD, Nerviano Medical Sciences, Roche, Servier, Taiho Oncology, Zymeworks; Financial Interests, Personal, Other, Lecture fees: AstraZeneca, Bayer, BMS, Incyte, Ipsen, Roche, Servier; Financial Interests, Personal, Other, Travel expenses: AstraZeneca; Financial Interests, Institutional, Other, Research funding: Agios, AstraZeneca, BeiGene, Eisai, Exelixis, FibroGen, Incyte, Ipsen, Lilly, MSD, Nerviano Medical Sciences, Roche, Servier, Zymeworks. All other authors have declared no conflicts of interest.