不可切除的局部晚期及初发性转移性胰腺导管腺癌的真实世界临床结局：一项多中心回顾性研究。

Real-world clinical outcome of unresectable locally advanced & de-novo metastatic pancreatic ductal adenocarcinoma: a multicentre retrospective study.

作者信息

Aseafan Mohamed, Alfakeeh Ali H, Tashkandi Emad, Mahrous Mervat, Alghamdi Mohammed, Alshamsan Bader, Al-Hajeili Marwan, Bakhsh Safwan, Alshammari Kanan, Almugbel Fahad A, Alfagih Abdulhameed H, Allehebi Ahmed, Montaser Mohamed, Elsafty Mohamed Hamdy, Elnaghi Khaled Abd Elaziz, Issa Ibrahim, Bakshi Eesa, AlSubaie Sadeem, AlMutairi Bandar, Mokhtar Hoda, Aboelatta Mohamed, Bukhari Nedal, Alzahrani Ali M, Elhassan Tusneem, Alqahtani Ali, Bazarbashi Shouki

机构信息

Section of Medical Oncology, Department of Internal Medicine, Security Forces Hospital, Riyadh, Saudi Arabia.

Comprehensive Cancer Center, Medical Oncology, King Fahad Medical City, Riyadh, Saudi Arabia.

出版信息

BMC Cancer. 2025 Jan 3;25(1):7. doi: 10.1186/s12885-024-13386-0.

DOI:10.1186/s12885-024-13386-0

PMID:39754118

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11697791/

Abstract

BACKGROUND

Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal malignancies, with limited treatment options yielding poor outcomes. This study aimed to evaluate the real-world clinical characteristics, treatment patterns, and outcomes of patients with locally advanced unresectable and de-novo metastatic PDAC in Saudi Arabia, providing regional data to compare with international benchmarks.

METHODS

This is a retrospective, multicentre study involving 350 patients diagnosed with unresectable locally advanced or de-novo metastatic PDAC between January 2015 and November 2023. Data were collected from 10 oncology centers across Saudi Arabia.

RESULTS

The median age at diagnosis was 60 years, with 63% of patients presenting with multiple metastatic sites, primarily in the liver (66.3%). FOLFIRINOX was the most common first-line treatment (55.1%), followed by gemcitabine plus nab-paclitaxel (15.1%). The median PFS for first-line treatment was 5.3 months, with FOLFIRINOX achieving the longest PFS (6.5 months). The median OS was 10.34 months for the entire cohort, with better survival outcomes observed in patients receiving FOLFIRINOX (12.3 months). Independent prognostic factors for PFS and OS included performance status, first-line regimen, and neutrophil-lymphocyte ratio (NLR). Among patients tested, 7.1% had deficient mismatch repair (d-MMR), and 5.8% harbored BRCA mutations.

CONCLUSIONS

This real-world study confirms that clinical outcomes for locally advanced unresectable and metastatic PDAC in Saudi Arabia are consistent with international data, with FOLFIRINOX showing superior outcomes over gemcitabine-based regimens. However, both treatments reflect the persistent poor prognosis of PDAC, underscoring the need for novel therapeutic strategies. Further research is warranted to optimize treatment selection and improve survival outcomes in this population.

摘要

背景

胰腺导管腺癌（PDAC）仍然是最致命的恶性肿瘤之一，治疗选择有限，预后较差。本研究旨在评估沙特阿拉伯局部晚期不可切除和初发转移性PDAC患者的真实世界临床特征、治疗模式和结局，提供区域数据以与国际基准进行比较。

方法

这是一项回顾性多中心研究，纳入了2015年1月至2023年11月期间诊断为不可切除局部晚期或初发转移性PDAC的350例患者。数据来自沙特阿拉伯的10个肿瘤中心。

结果

诊断时的中位年龄为60岁，63%的患者有多个转移部位，主要在肝脏（66.3%）。FOLFIRINOX是最常见的一线治疗方案（55.1%），其次是吉西他滨联合白蛋白结合型紫杉醇（15.1%）。一线治疗的中位无进展生存期（PFS）为5.3个月，FOLFIRINOX的PFS最长（6.5个月）。整个队列的中位总生存期（OS）为10.34个月，接受FOLFIRINOX治疗的患者生存结局更好（12.3个月）。PFS和OS的独立预后因素包括体能状态、一线治疗方案和中性粒细胞与淋巴细胞比值（NLR）。在检测的患者中，7.1%存在错配修复缺陷（d-MMR），5.8%携带BRCA突变。