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. 2019 Jul 4;11(7):939.
doi: 10.3390/cancers11070939.

Early Tumor Shrinkage and Depth of Response Evaluation in Metastatic Pancreatic Cancer Treated with First Line Chemotherapy: An Observational Retrospective Cohort Study

Caterina Vivaldi  1   2 , Lorenzo Fornaro  3 , Carla Cappelli  4 , Irene Pecora  3 , Silvia Catanese  3 , Francesca Salani  3 , Andrea Cacciato Insilla  5 , Emanuele Kauffmann  6 , Francescamaria Donati  4 , Giulia Pasquini  3 , Valentina Massa  3 , Niccolò Napoli  6 , Monica Lencioni  3 , Piero Boraschi  4 , Daniela Campani  5 , Ugo Boggi  6 , Davide Caramella  7 , Alfredo Falcone  8   3 , Enrico Vasile  3
Affiliations

Early Tumor Shrinkage and Depth of Response Evaluation in Metastatic Pancreatic Cancer Treated with First Line Chemotherapy: An Observational Retrospective Cohort Study

Caterina Vivaldi et al. Cancers (Basel). .

Abstract

Early tumor shrinkage (ETS) and depth of response (DoR) predict favorable outcomes in metastatic colorectal cancer. We aim to evaluate their prognostic role in metastatic pancreatic cancer (PC) patients treated with first-line modified-FOLFIRINOX (FOLFOXIRI) or Gemcitabine + Nab-paclitaxel (GemNab). Hence, 138 patients were tested for ETS, defined as a ≥20% reduction in the sum of target lesions' longest diameters (SLD) after 6-8 weeks from baseline, and DoR, i.e., the maximum percentage shrinkage in the SLD from baseline. Association of ETS and DoR with progression-free survival (PFS) and overall survival (OS) was assessed. ETS was reached in 49 patients (39.5% in the FOLFOXIRI, 29.8% in the GemNab group; p = 0.280). In the overall population, ETS was significantly associated with better PFS (8.0 vs. 4.8 months, p < 0.001) and OS (13.2 vs. 9.7 months, p = 0.001). Median DoR was -27.5% (-29.4% with FOLFOXIRI and -21.4% with GemNab, p = 0.016): DoR was significantly associated with better PFS (9.0 vs. 6.7 months, p < 0.001) and OS (14.3 vs. 11.1 months, p = 0.031). Multivariate analysis confirmed both ETS and DoR are independently associated with PFS and OS. In conclusion, our study added evidence on the role of ETS and DoR in the prediction of outcome of PC patients treated with first-line combination chemotherapy.

Keywords: FOLFOXIRI; depth of response; early tumor shrinkage; gemcitabine plus nab-paclitaxel; pancreatic cancer.

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Conflict of interest statement

L.F. received speaking honoraria from Eli Lilly and travel grants from Celgene. The other authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Progression-free survival (a) and overall survival (b) according to ETS values in overall population.
Figure 2
Figure 2
Progression-free survival (a) and overall survival (b) according to ETS in FOLFOXIRI and GemNab group.
Figure 3
Figure 3
Progression-free Survival (a) and Overall Survival (b) curves according to DoR quartiles in overall population.
Figure 4
Figure 4
Progression-free survival (a) and overall survival (b) curves according to DoR ≥ vs. < median value in FOLFOXIRI and GemNab groups.
Figure 4
Figure 4
Progression-free survival (a) and overall survival (b) curves according to DoR ≥ vs. < median value in FOLFOXIRI and GemNab groups.
See this image and copyright information in PMC

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