Original Article
Ilya Pokataev, Anna Popova, Al
Abstract
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.