Multicenter Retrospective Analysis of Chemotherapy for Advanced Pancreatic Acinar Cell Carcinoma

Abstract

Objectives The aim of this multicenter retrospective study was to identify the optimal chemotherapeutic regimen for advanced pancreatic acinar cell carcinoma (PACC). Methods Fifty-eight patients with histopathologically confirmed advanced PACC who had received chemotherapy between 1996 and 2013 were enrolled. The clinical characteristics of the patients and the treatment efficacy data were collected from the medical records at 16 Japanese institutions, using standardized data collection instrument. Results The most commonly selected treatment regimens were gemcitabine-, fluoropyrimidine-, platinum-, and irinotecan-containing regimens. The overall response rate in the patients who received first-line chemotherapy were 7% and 38%, respectively, and the median overall survival was 13.2 months. When the data for all the treatment lines were aggregated, the response rates to gemcitabine-, fluoropyrimidine-, platinum-, and irinotecan-containing regimens were 7%, 18%, 40%, and 29%, respectively. The overall survival tended to be better in patients who had received a platinum-containing regimen (hazard ratio, 0.50; 95% confidence interval, 0.23–1.11; P = 0.08) or irinotecan-containing regimen (hazard ratio, 0.42; 95% confidence interval, 0.15–1.19; P = 0.09) at least once in the treatment course as compared with those who had not. Conclusions Our findings suggested that platinum- and irinotecan-containing regimens exhibited some potential efficacy in patients with advanced PACC.

Survival Outcome and Prognostic Factors for Pancreatic Acinar Cell Carcinoma: Retrospective Analysis from the German Cancer Registry Group

“…Most of the NCBI/SEER-based studies reported a median age of PACC patients about 65 years. Patients in the two Japanese publications, Kitagami et al and Takahashi et al, were younger with median ages 60 and 61 years [ 9 , 22 ]. In the current study, the median age for PACC patients was 66 years, compared to 70 years for PDAC patients ( p < 0.001).…”

“…Furthermore, the most common regime of adjuvant chemotherapy given for PACC was gemcitabine monotherapy in 30 patients (60% of patients with adjuvant chemotherapy). The results of several previous studies suggest that gemcitabine monotherapy might not lead to a response in PACC patients but, rather, platin-based regimes should be given preference [ 4 , 9 , 23 , 32 , 33 , 34 ]. Thus, the lack of overall survival benefit of adjuvant therapy in our study might also be due to the high proportion of patients with gemcitabine monotherapy.…”

“…Many of these studies point out surgical resection as the most effective therapeutic strategy [ 2 , 3 , 4 , 5 , 7 ]. The survival benefit of systemic therapy is more controversial [ 3 , 8 , 9 ].…”

Synchronous concomitant pancreatic acinar cell carcin and gastric adenocarcinoma: A case report and review of literature

“…The treatment regimens have not yet been standardized. Takahashi et al [ 38 ] reported that platinum-containing regimens exhibited some potential efficacy in patients with advanced PACC. The response to platinum-containing regimens was 40%, and the overall survival tended to be better in patients who had received a platinum-containing regimen[ 38 ].…”

“…Takahashi et al [ 38 ] reported that platinum-containing regimens exhibited some potential efficacy in patients with advanced PACC. The response to platinum-containing regimens was 40%, and the overall survival tended to be better in patients who had received a platinum-containing regimen[ 38 ]. Simultaneous removal of concomitant primary carcinomas should be attempted; radiotherapy and chemotherapy should also be considered for patients who need adjuvant treatment decided by both disease stages[ 39 ].…”