Early tumor shrinkage improves survival in pancreatic cancer
For patients with recurrent and metastatic pancreatic cancer who received chemotherapy as a first-line treatment, early tumor shrinkage correlated with an improved rate of progression-free survival and overall survival.
“Despite the availability of various types of treatment regimens for advanced pancreatic cancer (PC), there is a lack of factors that define the precocity or depth of tumor regression and can reliably anticipate prognosis as the first-line of therapy. Early tumor shrinkage (ETS) implies a depletion ( 20%) in tumor burden. ... Depth of response (DpR) is classified as the largest decrease in the tumor size,” Xiaojuan Yang, Sichuan University, and colleagues wrote in BMC Gastroenterology. “The prognostic potential of DpR and ETS in advanced PC patients who received chemotherapy as the first-line therapy is not completely understood, and thus, it is unclear whether the prognostic potential is independent of treatment administration.”
In a retrospective, single-center study, researchers recruited 90 patients with at least one 10 mm lesion who underwent four cycles of an assigned first-line therapy regimen. They further compared the sum of the longest diameters (SLD) of tumor lesions at 6 weeks to 12 weeks after treatment initiation with baseline measures. Co-primary endpoints included the prognostic value between ETS and DpR with progression-free survival as well as overall survival.
Investigators evaluated 63 patients for ETS, noting 33.3% of these patients achieved ETS. The median reduction of the SLD from baseline was 10.22% and the median DpR was –23.66%. Researchers observed that incidence of ETS correlated with an improved rate of progression-free survival (6.5 months vs. 2.2 months) and overall survival (12.1 months vs. 6 months) as did DpR (9.3 months vs. 3.1 months and 18.2 months vs. 7.3 months, respectively). Among the whole study population, a multivariable model confirmed ETS and DpR were independent predictors of overall survival.
“Earlier and deeper tumor shrinkage could anticipate the survival of advanced PC patients,” Yang and colleagues concluded. “These findings need further validation before using ETS and DpR in routine procedures of patient management.”