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ORIGINAL ARTICLE
Year : 2017  |  Volume : 13  |  Issue : 2  |  Page : 240-245

Prognostic and predictive markers of response to treatment in patients with locally advanced unresectable and metastatic pancreatic adenocarcinoma treated with gemcitabine/nab-paclitaxel: Results of a retrospective analysis


1 Departament of Medical Oncology, Complexo Hospitalario Universitario de Ourense, Ourense, Spain
2 Departament of Medical Oncology, Complexo Hospitalario Universitario de Vigo, Pontevedra, Spain
3 Departament of Medical Oncology, Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain
4 Departament of Medical Oncology, Complexo Hospitalario Universitario de Ferrol, Ferrol, A Coruña, Spain
5 Departament of Medical Oncology, Hospital Lucus Augusti, Lugo, Spain
6 Departament of Medical Oncology, Hospital de Pontevedra, Pontevedra, Spain

Correspondence Address:
Ana Fernández Montes
Departament of Medical Oncology, Complexo Hospitalario Universitario de Ourense, Servicio de Oncología Médica, E-32005 Ourense
Spain
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-1482.181181

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Background: Recent studies support the use of gemcitabine and nab-paclitaxel in adults with locally advanced unresectable or metastatic pancreatic adenocarcinoma although insufficient data are available on prognostic and predictive markers of response to treatment. Objective: The objective of this study is to identify treatment response markers in patients with locally advanced unresectable or metastatic pancreatic adenocarcinoma. Materials and Methods: This is an observational, retrospective, and multicenter study. Sociodemographic, clinical, and therapeutic data were collected. Cox regression models were applied to determine associations. Results: In total, 39 patients were included; 23.1% presented locally advanced pancreatic cancer and 76.9% metastatic disease. They received a mean of 6 ± 3 treatment cycles; 59% required dose reduction, 59% treatment delay, and 20.5% switched to a biweekly regimen. The overall response rate was 23% and the disease control rate was 81%. Median progression-free survival was 9 months and median overall survival (OS) was 15 months. A higher neutrophil/lymphocyte ratio (NLR) was significantly associated with lower OS. We reported Grades 1–4 nonhematological and hematological toxicities. Conclusion: NLR is a useful prognostic factor for OS in patients with locally advanced unresectable or metastatic pancreatic adenocarcinoma treated with gemcitabine and nab-paclitaxel. Moreover, we suggest that a biweekly regimen is an option for certain groups of patients.


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