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Chemotherapy-induced neutropenia as a prognostic factor in patients with unresectable pancreatic cancer

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Abstract

Purpose

We conducted a retrospective cohort study to examine whether neutropenia could be an indicator of good prognosis in patients treated with gemcitabine (GEM) for unresectable pancreatic cancer.

Methods

A total of 178 patients with unresectable pancreatic cancer, who were treated with first-line (n = 121) or second-line (n = 57) GEM, were included in our analyses. A Cox proportional hazard model was used to examine the effect of the grade of GEM-induced neutropenia on prognosis. Furthermore, the difference in survival time for each grade was assessed using a log-rank test.

Results

In the first-line population, the hazard ratios of patients with grade 2 or grade 3 neutropenia compared with the ratios of those without neutropenia (grade 0) were 0.43 (95% CI 0.27–0.70) and 0.37 (0.21–0.65), respectively (p < 0.05). The median survival time (MST) was 3.8 months for grade 0, 9.4 months for grade 2, and 10.1 for grade 3. Landmark analysis of the second-line population revealed a hazard ratio of 0.52 (0.30–0.82) for grade 1 and 0.49 for grade 2 (0.28–0.72) (p < 0.05). MST was 1.3 months for grade 0, 4.7 months for grade 1, and 4.6 months for grade 2.

Conclusions

We found that neutropenia grade was an indicator of good prognosis in patients treated with first-line and second-line GEM for unresectable pancreatic cancer. A prospective study should be performed to examine whether dosage adjustment using neutropenia grade as an indicator would improve prognosis.

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Acknowledgments

We thank Jun Kawazoe, Emi Katsumoto, Wakana Kato, Saori Mochida, Megumi Mori, who are students at the Showa University School of Pharmacy, for their technical assistance.

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Authors and Affiliations

  1. Division of Physiology and Pathology, Department of Pharmacology, Toxicology and Therapeutics, Showa University School of Pharmacy, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan

    Tatsuya Kurihara, Masakazu Ishii & Shunichi Shimizu

  2. Department of Hospital Pharmaceutics, Showa University School of Pharmacy, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan

    Mari Kogo

  3. Division of Medical Oncology, Department of Medicine, Showa University Koto-Toyosu Hospital, 1-5-8 Hatanodai, Koto-ku, Tokyo, 135-0061, Japan

    Ken Shimada

  4. Health Service Center, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan

    Keiichiro Yoneyama

  5. Division of Gastroenterology, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan

    Katsuya Kitamura & Hitoshi Yoshida

  6. Center of Pharmaceutical Education, School of Pharmaceutical Sciences, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan

    Yuji Kiuchi

Authors
  1. Tatsuya Kurihara
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  2. Mari Kogo
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  3. Masakazu Ishii
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  9. Yuji Kiuchi
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Correspondence to Tatsuya Kurihara.

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Kurihara, T., Kogo, M., Ishii, M. et al. Chemotherapy-induced neutropenia as a prognostic factor in patients with unresectable pancreatic cancer. Cancer Chemother Pharmacol 76, 1217–1224 (2015). https://doi.org/10.1007/s00280-015-2887-4

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  • DOI: https://doi.org/10.1007/s00280-015-2887-4

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