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

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

来源：Cancer Chemotherapy and Pharmacology, 2013, 72(6): 1291-1297.

DOI：10.1007/s00280-013-2313-8

• CA19-9
• Chemotherapy
• Pancreatic cancer
• Prognostic factor
• Refractory

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.
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.
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 a parts per thousand yen50 % versus < 50 % increase. In the multivariate analyses, CA19-9 increase a parts per thousand yen50 % was prognostic of both PFS and OS (HR 2.28 and 2.50, p < 0.001, respectively).
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.

• 出版日期2013-12