Department of Clinical Oncology, Higashiosaka City Medical Center, Higashiosaka, Japan.
Department of Gastroenterological Surgery, Higashiosaka City Medical Center, Higashiosaka, Japan.
Cancer Rep (Hoboken). 2020 Apr;3(2):e1215. doi: 10.1002/cnr2.1215. Epub 2019 Aug 28.
Second-line (2 L) chemotherapy is important for improved survival. However, the efficacy of S-1 after nab-paclitaxel plus gemcitabine (AG) for advanced pancreatic cancer (APC) remains unclear.
We retrospectively investigated the clinical impact of S-1 after AG.
From January 2015 to July 2018, 37 patients with APC underwent AG as first-line chemotherapy at our institute. Of these patients, 14 (38%) underwent S-1 as 2 L chemotherapy after AG (S-1 group), five (14%) received another agent after AG, and 18 (49%) underwent no 2 L chemotherapy (best supportive care [BSC] group). The clinical features were retrospectively compared between the S-1 and BSC groups. Prognostic factors for residual survival (RS) were analyzed using a Cox proportional hazards model. The induction rate of 2 L chemotherapy was 51%, and most patients received S-1 monotherapy (74%). The disease control rate and progression-free survival duration were 57.1% and 2.8 months, respectively. The median RS duration in the S-1 and BSC groups was 5.2 and 2.4 months, respectively; this difference was statistically significant (hazard ratio, 0.33; P = .005). The median overall survival duration in the S-1 and BSC groups was 12.3 and 5.0 months, respectively; this difference was also statistically significant (hazard ratio, 0.26; P = .001). The efficacy of S-1 in 2L chemotherapy for RS was identified in the multivariate analysis, as was age (<65 vs ≥65 y) and the presence of liver metastasis.
The antitumor activity of S-1 was retained after AG, and the induction of S-1 after AG might improve the prognosis of patients with APC.
二线（2L）化疗对于提高生存率很重要。然而，对于晚期胰腺癌（APC）患者，S-1 联合 nab-紫杉醇加吉西他滨（AG）治疗后的疗效尚不清楚。
我们回顾性研究了 AG 后 S-1 的临床影响。
2015 年 1 月至 2018 年 7 月，我院收治的 37 例 APC 患者接受 AG 作为一线化疗。其中，14 例（38%）在 AG 后接受 S-1 作为 2L 化疗（S-1 组），5 例（14%）在 AG 后接受其他药物治疗，18 例（49%）未接受 2L 化疗（最佳支持治疗[BSC]组）。回顾性比较 S-1 组和 BSC 组的临床特征。采用 Cox 比例风险模型分析残留生存期（RS）的预后因素。2L 化疗的诱导率为 51%，大多数患者接受 S-1 单药治疗（74%）。疾病控制率和无进展生存期分别为 57.1%和 2.8 个月。S-1 组和 BSC 组的中位 RS 持续时间分别为 5.2 个月和 2.4 个月，差异有统计学意义（风险比，0.33；P=0.005）。S-1 组和 BSC 组的中位总生存期分别为 12.3 个月和 5.0 个月，差异有统计学意义（风险比，0.26；P=0.001）。多因素分析显示，2L 化疗中 S-1 的疗效，以及年龄（<65 岁与≥65 岁）和肝转移的存在，均与 RS 有关。
AG 后 S-1 的抗肿瘤活性仍然存在，AG 后诱导 S-1 可能改善 APC 患者的预后。
