Safety and feasibility of S-1 adjuvant chemotherapy for pancreatic cancer in elderly patients

Aoyama, Toru; Katayama, Yusuke; Murakawa, Masaaki; Atsumi, Yoshihito; Yamaoku, Koichiro; Kanazawa, Amane; Higuchi, Akio; Shiozawa, Manabu; Kobayashi, Satoshi; Ueno, Makoto; Morimoto, Manabu; Yamamoto, Naoto; Oshima, Takashi; Yoshikawa, Takaki; Rino, Yasushi; Masuda, Munetaka; Morinaga, Soichiro

doi:10.1007/s00280-015-2736-5

Cited by 6 publications

(4 citation statements)

References 16 publications

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“…ROC analysis showed that in PDAC prognosis evaluation (in combined datasets), this 6-mRNA signature was superior to age, histology grade and TNM stage. Many clinical parameters might affect the survival after PDAC surgery like histologic grade, TNM stage, serum CA19-9, perioperative blood transfusion, and metastasis to lymph nodes 43-49. To enhance prognostic prediction, 6-mRNA risk score was combined with age, histologic grade and tumor stage.…”

Section: Discussionmentioning

confidence: 99%

A robust 6-mRNA signature for prognosis prediction of pancreatic ductal adenocarcinoma

Zhou¹,

Zhao²,

Yin³

et al. 2019

Int. J. Biol. Sci.

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Pancreatic ductal adenocarcinoma (PDAC) is one of the most fatal malignancies worldwide. PDAC prognostic and diagnostic biomarkers are still being explored. The aim of this study is to establish a robust molecular signature that can improve the ability to predict PDAC prognosis. 155 overlapping differentially expressed genes between tumor and non-tumor tissues from three Gene Expression Omnibus (GEO) datasets were explored. A least absolute shrinkage and selection operator method (LASSO) Cox regression model was employed for selecting prognostic genes. We developed a 6-mRNA signature that can distinguish high PDAC risk patients from low risk patients with significant differences in overall survival (OS). We further validated this signature prognostic value in three independent cohorts (GEO batch, P < 0.0001; ICGC, P = 0.0036; Fudan, P = 0.029). Furthermore, we found that our signature remained significant in patients with different histologic grade, TNM stage, locations of tumor entity, age and gender. Multivariate cox regression analysis showed that 6-mRNA signature can be an independent prognostic marker in each of the cohorts. Receiver operating characteristic curve (ROC) analysis also showed that our signature possessed a better predictive role of PDAC prognosis. Moreover, the gene set enrichment analysis (GSEA) analysis showed that several tumorigenesis and metastasis related pathways were indeed associated with higher scores of risk. In conclusion, identifying the 6-mRNA signature could provide a valuable classification method to evaluate clinical prognosis and facilitate personalized treatment for PDAC patients. New therapeutic targets may be developed upon the functional analysis of the classifier genes and their related pathways.

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Section: Discussionmentioning

confidence: 99%

A robust 6-mRNA signature for prognosis prediction of pancreatic ductal adenocarcinoma

Zhou¹,

Zhao²,

Yin³

et al. 2019

Int. J. Biol. Sci.

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“…These studies suggested that subtypes of gastric cancer may be important predictors for patients with gastric cancer who could benefit from chemotherapy. In clinical practice, oncologists are more likely to prescribe single agent chemotherapy for older patients or patients at earlier stage according to their physical condition [21, 22]. However, our result demonstrated that intensive two-drug chemotherapy regimen is better than mild chemotherapy in disease-free survival after curative resection with gastric cancer.…”

Section: Discussionmentioning

confidence: 73%

Comparison of efficacy in adjuvant chemotherapy regimens in patients with radically resected gastric cancer: a propensity-matched analysis

et al. 2016

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BackgroundWe conducted the retrospective study to compare the efficacy of monotherapies versus two-drug regimens as postoperative chemotherapy for patients with radically resected gastric cancer.ResultAt a median follow-up of 5.3 years, no significant difference in terms of OS was observed between two groups, neither before nor after matching. After matching, median DFS was statistically significant between group A and B (median, 67.5 vs 101.0 months, respectively; hazard ratio [HR], 0.65; 95% CI, 0.45 to 0.95; P=0.027), which meant doublets prolonged DFS. In subgroup analysis, the patients of stage III receiving doublet achieved better OS than those receiving monotherapy. People who received doublet and were less than 65 years old, or male patients, or in T4 stage, or in N2 stage, or receiving subtotal gastrectomy had better DFS than those with monotherapy.MethodA data set including 501 patients (monotherapy, n=107; doublet, n=394) was matched between the two groups (n=107 patients per group) using the propensity-matched study. The primary and secondary endpoint was overall survival(OS) and disease-free survival(DFS), respectively. Survival data was compared using the Kaplan-Meier method and Cox proportion hazards models for univariate and multivariate analyses.ConclusionThe dual regimens seemed not to add overall survival benefits to patients receiving curative gastrectomy, compared with single-agent fluoropyrimidine as postoperative chemotherapy. However, dual regimens showed better disease-free survival.

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“…Patients 70 years and older are less likely to receive adjuvant chemotherapy although this treatment approach is associated with prolonged survival [26]. Aoyama et al reported that the safety and feasibility of S-1 adjuvant chemotherapy were similar between patients older than 70 years of age and those younger than 70 years of age [27]. In the JASPAC-01 trial [11], including participants aged 20 years or older, the median age of patients assigned to the S-1 arm was 66 (range, 60-73) years.…”

Section: Discussionmentioning

confidence: 99%

Skeletal Muscle Loss and Octogenarian Status Are Associated with S-1 Adjuvant Therapy Discontinuation and Poor Prognosis after Pancreatectomy

Tsukagoshi

Harimoto

Araki

et al. 2021

Cancers

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The efficacy and prognosis of adjuvant chemotherapy for resected pancreatic cancer remain unclear. We investigated the utility and risk factors of S-1 adjuvant chemotherapy in patients with pancreatic cancer undergoing pancreatectomy. This study comprised 80 patients, including 58 patients who received S-1 adjuvant chemotherapy. Skeletal muscle loss was defined using cutoff values of skeletal muscle mass index. In total, 16 (20%) octogenarian patients underwent pancreatectomy. Skeletal muscle loss was present in 56 (70%) patients. The entire course of S-1 adjuvant chemotherapy for 6 months was completed in 33 patients (41%). S-1 adjuvant chemotherapy <6 months was an independent prognostic indicator of poor overall survival. Patients who completed S-1 adjuvant chemotherapy exhibited significantly longer overall and relapse-free survival rates than those did not complete the chemotherapy (p <0.0001 and p = 0.0003, respectively). Being an octogenarian and skeletal muscle loss were independent variables associated with the discontinuation of S-1 adjuvant chemotherapy. Finally, the S-1 adjuvant chemotherapy rates were 6.3% (1/16) and 28.6% (16/56) in octogenarian patients and those with skeletal muscle loss, respectively. S-1 adjuvant chemotherapy completion was associated with improved prognosis in patients with pancreatic cancer. Skeletal muscle loss and octogenarian status predicted the failure of S-1 adjuvant chemotherapy completion.

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Safety and feasibility of S-1 adjuvant chemotherapy for pancreatic cancer in elderly patients

Abstract: These results suggest that S-1 adjuvant chemotherapy for pancreatic cancer is safe and feasible, regardless of the age of the patient, especially for elderly patients who may be candidates for clinical trials.

Cited by 6 publications

References 16 publications

A robust 6-mRNA signature for prognosis prediction of pancreatic ductal adenocarcinoma

A robust 6-mRNA signature for prognosis prediction of pancreatic ductal adenocarcinoma

Comparison of efficacy in adjuvant chemotherapy regimens in patients with radically resected gastric cancer: a propensity-matched analysis

Skeletal Muscle Loss and Octogenarian Status Are Associated with S-1 Adjuvant Therapy Discontinuation and Poor Prognosis after Pancreatectomy

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