Depth of response in patients with locally advanced pancreatic cancer treated with first-line chemotherapy: A supplementary analysis of JCOG1407
- PMID: 39984379
- DOI: 10.1016/j.pan.2025.02.005
Depth of response in patients with locally advanced pancreatic cancer treated with first-line chemotherapy: A supplementary analysis of JCOG1407
Abstract
Background/objectives: Depth of response (DpR; maximum % reduction from baseline in sum of the target lesion diameters) has demonstrated potential in predicting prognosis in several malignancies. However, its role in locally advanced pancreatic cancer (LAPC) is still unclear. In JCOG1407, modified FOLFIRINOX (mFOLFIRINOX) and gemcitabine plus nab-paclitaxel (GnP) exhibited comparable efficacy for LAPC. In this exploratory analysis using the data of JCOG1407, we focused on the association between DpR and prognosis.
Methods: DpR was classified into three groups at the tertile point and patients' backgrounds and survival were compared. The impact of DpR on survival outcomes was evaluated using the multivariable Cox proportional hazard model.
Results: Of the 126 patients enrolled in JCOG1407, 109 patients were included, categorized into three DpR groups: T1 (<-37.2 %), T2 (-37.2 to -13.6 %), and T3 (>-13.6 %). The median DpR was significantly greater in the GnP arm than in the mFOLFIRINOX arm (-28.9 vs. -22.7 %, P = 0.041). Median duration of response tended to be shorter in the GnP arm than in the mFOLFIRINOX arm, although the difference was not significant (5.3 vs. 8.2 months, P = 0.132). Greater DpR (T1) had a significantly larger impact on better progression-free survival (PFS) and overall survival (OS) than T3, with the hazard ratio of 0.469 (95 % confidence interval [CI] 0.268-0.821, P = 0.008), and 0.398 (95 % CI 0.217-0.728, P = 0.003), respectively.
Conclusions: mFOLFIRINOX and GnP had similar OS, it is noteworthy that the regimens exhibited differences in DpR, with GnP leading to greater DpR. Greater DpR are associated with improved survival in patients with LAPC.
Keywords: Depth of response; Gemcitabine plus nab-paclitaxel; Locally advanced pancreatic cancer; mFOLFIRINOX.
Copyright © 2025 The Authors. Published by Elsevier B.V. All rights reserved.
Conflict of interest statement
Disclosure of potential conflicts of interests Masafumi Ikeda reports having received grants from the Ministry of Health, Labour, and Welfare, Japan, and grants from Japan AMED during the study, as well as grants from Chugai Pharmaceutical, Yakult Honsha, Nihon Servier, Chiome Bioscience, Bayer, Ono Pharmaceutical, Bristol Myers Squibb, Eisai, Merck Serono, Delta-Fly Pharma, MSD, J-Pharma, Pfizer, ASLAN Pharmaceuticals, Eli Lilly Japan, Takeda, AstraZeneca, and Merus N.V, and personal fees from Chugai Pharmaceutical, Yakult Honsha, Nihon Servier, Bristol Myers Squibb, Taiho Pharmaceutical, Bayer, Eisai, MSD, Astellas, Sumitomo Dainippon, Otsuka Pharmaceutical, GlaxoSmithKline, Eli Lilly Japan, Takeda, AstraZeneca, AbbVie, and Abbott Japan outside the scope of the submitted work. Satoshi Kobayashi reports having received grants and non-financial support from the Ministry of Health, Labour, and Welfare, Japan, and grants and non-financial support from Japan AMED during the study, as well as personal fees from Bayer Yakuhin, Chugai Pharma, Eisai, Eli Lilly, GlaxoSmithKline, Taiho Pharmaceutical, Takeda, Yakult Honsha outside the scope of the submitted work. Akihiro Ohba reports having received grants from Ono, Chugai, Novartis, Daiichi Sankyo, and MSD, honoraria from Yakult, Ono, Servier, Taiho, Eisai, AstraZeneca, GUardant, and MSD, and was a member of an advisory board for Jazz and Servier. Akiko Todaka reports having received grants from the Ministry of Health, Labour, and Welfare, Japan, and grants from Japan AMED, during the study, as well as personal fees from Taiho Pharmaceutical, Yakult Honsha, Ono Pharmaceutical, Nihon Servier, AstraZeneca, Novartis, and Teijin Pharma outside the scope of submitted work. Masashi Kanai reports having received grants from the Chugai Pharmaceutical and AstraZeneca. Junji Furuse reports having received grants from the Ministry of Health, Labour, and Welfare, Japan, and grants from Japan AMED, during the study, as well as grants from Ono Pharmaceutical, MSD, Merck Biopharma, J-Pharma, Taiho Pharmaceutical, Takeda Pharmaceutical, Chugai Pharmaceutical, AstraZeneca, Yakult Honsha, Eisai, Daiichi Sankyo, Mochida Pharmaceutical, Sanofi, Sumitomo Dainippon, Bayer, Astellas, and Incyte Japan, and personal fees from Fujifilm, Mudi Pharma, OncoTherapy Science, Merck Biopharma, Ono Pharmaceutical, MSD, Taiho Pharmaceutical, Chugai Pharmaceutical, Astellas, AstraZeneca, Takara Bio, Delta-Fly Pharma, Incyte Japan, Bayer, Eisai, Eli Lilly Japan, Yakult Honsha, Novartis, Pfizer, Takeda Pharmaceutical, Sanofi, Mylan EPD, EA Pharma, Kyowa Hakko Kirin, Daiichi Sankyo, Teijin Pharma, and Servier outside the scope of the submitted work. Yusuke Kumamoto reports having received grants from Taiho Pharmaceutical, Chugai Pharma, Kaken Pharmaceutical, Terumo, Otsuka Pharmaceutical. Masato Ozaka reports having received grants and non-financial support from the Ministry of Health, Labour, and Welfare, Japan, and grants from the Japan Agency for Medical Research and Development (AMED), during the study, as well as personal fees from Taiho Pharmaceutical, Yakult Honsha, MSD, Ono Pharmaceutical, Nihon Servier, Bayer, and Pfizer outside the scope of the submitted work. Makoto Ueno reports grants from the Ministry of Health, Labour, and Welfare, Japan and grants from Japan AMED, during the study as well as grants from Taiho Pharmaceutical, AstraZeneca, Merck Biopharma, MSD, Astellas Pharma, Eisai, Ono Pharmaceutical, Incyte, Chugai Pharmaceutical, Delta-Fly Pharma, and Daiichi Sankyo and personal fees from Taiho Pharmaceutical, AstraZeneca, Merck Biopharma, MSD, Nihon Servier, Eisai, Ono Pharmaceutical, Incyte, and Chugai Pharmaceutical outside the scope of the submitted work.
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