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A retrospective analysis of early CA19-9 change in salvage chemotherapy for refractory pancreatic cancer

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Abstract

Purpose

In salvage chemotherapy for refractory pancreatic cancer, early assessment is important to avoid unnecessary toxicities from ineffective chemotherapy. Early CA19-9 change after the first course as a prognostic factor was evaluated in this setting.

Methods

Patients receiving salvage chemotherapy were retrospectively studied. CA19-9 was measured prior to and after the first course. Cox regression analysis was performed for prognostic factors for progression-free survival (PFS) and overall survival (OS), using the landmark method defined as a day of CA19-9 measurement after the first course.

Results

A total of 239 salvage regimens were given in 167 patients. Median PFS and OS were 2.7 and 6.1 months, respectively. Median pretreatment CA19-9 was 2,362 U/mL, and median CA19-9 change after the first course was 17.8 % increase. CA19-9 change was associated with tumor response, and PFS was 1.7 versus 3.5 months and OS was 3.9 and 8.6 months in patients with ≥50 % versus <50 % increase. In the multivariate analyses, CA19-9 increase ≥50 % was prognostic of both PFS and OS (HR 2.28 and 2.50, p < 0.001, respectively).

Conclusion

CA19-9 change after the first course was prognostic of PFS and OS in refractory pancreatic cancer. Early discontinuation should be considered given the palliative setting.

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Authors and Affiliations

  1. Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo, 113-8655, Japan

    Yousuke Nakai, Hiroyuki Isayama, Takashi Sasaki, Naminatsu Takahara, Tsuyoshi Hamada, Rie Uchino, Suguru Mizuno, Koji Miyabayashi, Keisuke Yamamoto, Dai Mohri, Hirofumi Kogure, Natsuyo Yamamoto, Kenji Hirano, Hideaki Ijichi, Keisuke Tateishi, Minoru Tada & Kazuhiko Koike

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  1. Yousuke Nakai
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  2. Hiroyuki Isayama
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  3. Takashi Sasaki
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  4. Naminatsu Takahara
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  5. Tsuyoshi Hamada
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  11. Hirofumi Kogure
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  13. Kenji Hirano
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  14. Hideaki Ijichi
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  15. Keisuke Tateishi
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  16. Minoru Tada
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  17. Kazuhiko Koike
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Corresponding author

Correspondence to Hiroyuki Isayama.

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Nakai, Y., Isayama, H., Sasaki, T. et al. A retrospective analysis of early CA19-9 change in salvage chemotherapy for refractory pancreatic cancer. Cancer Chemother Pharmacol 72, 1291–1297 (2013). https://doi.org/10.1007/s00280-013-2313-8

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  • DOI: https://doi.org/10.1007/s00280-013-2313-8

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