Ilya Pokataev, Anna Popova, Alexey Tryakin, Mikhail Fedyanin, Igor Bazin, Alexey Rumyantsev, Sergey Gordeev, Nikolay Kudashkin, Yuriy Patyutko, Sergei Tjulandin
Objectives We aimed to evaluate clinical factors that can predict second-line chemotherapy benefit in patients with pancreatic cancer. Methods In this retrospective study records of patients who received first-line chemotherapy since 2000 to 2015 were analyzed. A number of clinical and laboratory factors were evaluated for prognostic significance in a multivariate Cox proportional hazards model with overall survival as the end-point. Based on independent prognostic factors the prognostic model was constructed to dichotomize patients into two groups of prognosis. Results Records of 172 patients matched the inclusion criteria. Karnofsky performance status ≤70% and neutrophil-to-lymphocyte ratio >5 at the time of disease progression after first-line chemotherapy were independent poor prognostic factors. Administration of second-line chemotherapy improved outcome only in patients with favorable prognosis: median overall survival increased from 1.7 to 5.5 months for patients who received chemotherapy (n=23) and BSC (n=90), respectively (p=0.002). Median overall survival in the group of poor prognosis were 2.3 and 1.7 months for patients who received chemotherapy (n=20) or only BSC (n=39), respectively (p=0.233). Conclusion This novel prognostic model can potentially predict second-line chemotherapy benefit in patients with pancreatic cancer. However it needs to be validated in further trials.
