AI Article Synopsis

  • Pancreatic adenosquamous carcinoma (PASC) is a rare type of pancreatic cancer, and the study investigates the effectiveness of chemotherapy, particularly combination therapies, for treating patients with metastatic or recurrent PASC.
  • The analysis included data from 116 patients who received first-line chemotherapy at multiple institutions in Japan over a 16-year period, comparing outcomes between those on combination therapies and monotherapies.
  • Results indicated that combination therapies (like gemcitabine + nab-paclitaxel or fluorouracil/leucovorin + irinotecan + oxaliplatin) tended to provide better overall survival compared to monotherapy, suggesting they may be more beneficial for PASC patients.

Article Abstract

Background/objectives: Pancreatic 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.

Methods: We 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.

Results: Combination 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.

Conclusions: This 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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Source
http://dx.doi.org/10.1016/j.pan.2022.09.236DOI Listing

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