Efficacy of chemotherapy for patients with metastatic or recurrent pancreatic adenosquamous carcinoma: A multicenter retrospective analysis |
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| Affiliation: | 1. Division of Oncology and Hematology, Okinawa Chubu Hospital, Okinawa, Japan;2. Department of Gastroenterology, Kanagawa Cancer Center, Yokohama, Japan;3. Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan;4. Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan;5. Department of Biostatistics, Clinical Research Support Center, Shizuoka Cancer Center, Shizuoka, Japan;6. Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Japan;7. Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Japan;8. Division of Gastroenterology, Chiba Cancer Center, Chiba, Japan;9. Hepato-Biliary-Pancreatic Medicine Department, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan;10. Department of Medical Oncology, Kyorin University Faculty of Medicine, Tokyo, Japan;11. Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan;12. Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, Japan;13. Division of Cancer Center, Hokkaido University Hospital, Sapporo, Japan;14. Department of Gastroenterology, Kanazawa University, Kanazawa, Japan;15. Department of Gastroenterological Oncology, Hyogo Cancer Center, Hyogo, Japan;p. Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan;q. Department of Internal Medicine, Niigata Cancer Center Hospital, Niigata, Japan;r. Department of Gastrointestinal Medical Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan;s. Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan;t. Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan;u. Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan;v. Department of Hepato-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan;w. Department of Gastroenterology, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan;x. Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima, Japan;y. Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan;1. Moscow Clinical Scientific Centre, Moscow, Russia;2. Sechenov University, Moscow, Russia;3. Ilyinskaia Hospital, Moscow, Russia;4. First City Hospital Named After N.I. Pirogov, Moscow, Russia;1. Department of Radiology, Cincinnati Children''s Hospital Medical Center, Cincinnati, OH, USA;2. Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA;3. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA;4. Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children''s Hospital Medical Center, Cincinnati, OH, USA;5. Division of Endocrinology, Cincinnati Children''s Hospital Medical Center, Cincinnati, OH, USA;6. Division of Pediatric General and Thoracic Surgery, Cincinnati Children''s Hospital Medical Center, Cincinnati, OH, USA;1. Department of HPB Surgery and Transplantation, La Fe University Hospital and University of Valencia, Valencia, Spain;2. Department of General and Pancreatic Surgery, Verona Hospital Trust, University of Verona, Verona, Italy;3. Department of Nephrology and Kidney Transplantation, La Fe University Hospital and University of Valencia, Valencia, Spain;4. Department of Endocrinology, La Fe University Hospital and University of Valencia, Valencia, Spain;1. Department of Internal Medicine, Baylor College of Medicine, Houston, Tx, USA;2. Department of Medicine, Division of Gastroenterology, Baylor College of Medicine, Houston, Tx, USA;1. Division of Gastroenterology, Johns Hopkins Medical Institutions, Baltimore, MD, USA;2. Department of Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India;3. Division of Pediatric Gastroenterology, Lucile Packard Children''s Hospital Stanford, Palo Alto, CA, USA;4. Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, Netherlands;5. Department of Gastroenterology, Postgraduate Institute of Medical Education & Research, Chandigarh, India;6. Department of Gastroenterology, Apollo Multispecialty Hospitals, Kolkata, India;7. Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore;1. Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH, United States;2. Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States;3. Division of Gastroenterology and Hepatology, Johns Hopkins Medicine, Baltimore, MD, United States;4. Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis, MN, United States;5. Division of Gastroenterology, Rutgers Robert Wood Johnson, New Brunswick, NJ, United States;6. Division of Gastroenterology, Baylor College of Medicine, Houston, TX, United States;7. Division of Gastroenterology, UT Health San Antonio, San Antonio, TX, United States;8. Division of Gastroenterology, Baylor St. Luke''s Medical Center, Houston, TX, United States;9. Department of Urology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States;10. Division of Gastroenterology, Methodist Dallas Medical Center, Dallas, TX, United States |
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| Abstract: | ![]()
Background/objectivesPancreatic adenosquamous carcinoma (PASC) is a rare variant of pancreatic ductal adenocarcinoma (PDAC). The usual treatment for metastatic or recurrent PASC is systemic chemotherapy in accordance with the PDAC treatment strategy. This study aimed to investigate the efficacy of chemotherapy, especially the benefit of recent combination therapies, in patients with metastatic or recurrent PASC.MethodsWe conducted a multicenter retrospective analysis of 116 patients with metastatic or recurrent PASC treated with first-line chemotherapy between April 2001 and December 2017 at 24 Japanese institutions.ResultsCombination chemotherapies included gemcitabine + nab-paclitaxel (GnP, n = 28), fluorouracil/leucovorin + irinotecan + oxaliplatin (FFX, n = 10), gemcitabine + S-1 (GS, n = 10), and others (n = 9). Monotherapies included gemcitabine (n = 51) and S-1 (n = 8). The median overall survival (OS) was 6.5, 7.3, and 4.3 months for the whole cohort, the combination therapy group, and the monotherapy group, respectively. Multivariate analysis indicated that combination therapy showed a better trend in OS than monotherapy (hazard ratio = 0.68; 95% confidence interval, 0.38–1.20). GnP or FFX were selected in 58.7% of patients after FFX was approved in Japan, and revealed a median OS, median progression-free survival, and objective response rate of 7.3 months, 2.8 months, and 26.9% in GnP and 7.2 months, 2.3 months, and 20.0% in FFX respectively.ConclusionsThis study suggests that combination therapy may be more effective than monotherapy. GnP and FFX showed similar and clinically meaningful efficacy for patients with metastatic or recurrent PASC. |
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| Keywords: | Pancreatic cancer FOLFIRINOX Gemcitabine Nab-paclitaxel Pancreatic adenosquamous carcinoma |
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