TY - JOUR
T1 - Systemic Chemotherapy for Advanced Rare Pancreatic Histotype Tumors
T2 - A Retrospective Multicenter Analysis
AU - Brunetti, Oronzo
AU - Aprile, Giuseppe
AU - Marchetti, Paolo
AU - Vasile, Enrico
AU - Casadei Gardini, Andrea
AU - Scartozzi, Mario
AU - Barni, Sandro
AU - Delfanti, Sara
AU - De Vita, Fernando
AU - Di Costanzo, Francesco
AU - Milella, Michele
AU - Cella, Chiara Alessandra
AU - Berardi, Rossana
AU - Cataldo, Ivana
AU - Scarpa, Aldo
AU - Basile, Debora
AU - Mazzuca, Federica
AU - Graziano, Giusi
AU - Argentiero, Antonella
AU - Santini, Daniele
AU - Reni, Michele
AU - Cascinu, Stefano
AU - Silvestris, Nicola
PY - 2018/7
Y1 - 2018/7
N2 - OBJECTIVES: Two issues were put forth by clinicians in the management of the advanced stages of rare variants of pancreatic ductal adenocarcinoma and other exocrine histotypes with peculiar clinical and pathological features: Do chemotherapy regimens recommended in pancreatic ductal adenocarcinoma patients have a clinical activity in rare pancreatic tumors? Or should other chemotherapy combinations be considered in this subset of patients?METHODS: We conducted a multicenter retrospective study that collected data from 2005 to 2016 at 14 Italian cancer centers with the aim to evaluate tumor response and time to progression for first- and second-line and overall survival.RESULTS: Of approximately 4300 exocrine pancreatic cancer patients, 79 advanced cases affected by rare histological types were identified, with pancreatic acinar cell cancer (n = 23), pancreatic adenosquamous cancer (n = 16), and mucinous cystic neoplasm with an associated invasive mucinous cystadenocarcinoma (n = 15) most represented. Survival analyses for each subgroup in relation with the different chemotherapy regimens showed the lack of statistical significance correlations.CONCLUSIONS: Because of the lack of clinical trials in patients affected by these rare pancreatic histotypes, only their molecular classification would help clinicians in future therapeutic choice.
AB - OBJECTIVES: Two issues were put forth by clinicians in the management of the advanced stages of rare variants of pancreatic ductal adenocarcinoma and other exocrine histotypes with peculiar clinical and pathological features: Do chemotherapy regimens recommended in pancreatic ductal adenocarcinoma patients have a clinical activity in rare pancreatic tumors? Or should other chemotherapy combinations be considered in this subset of patients?METHODS: We conducted a multicenter retrospective study that collected data from 2005 to 2016 at 14 Italian cancer centers with the aim to evaluate tumor response and time to progression for first- and second-line and overall survival.RESULTS: Of approximately 4300 exocrine pancreatic cancer patients, 79 advanced cases affected by rare histological types were identified, with pancreatic acinar cell cancer (n = 23), pancreatic adenosquamous cancer (n = 16), and mucinous cystic neoplasm with an associated invasive mucinous cystadenocarcinoma (n = 15) most represented. Survival analyses for each subgroup in relation with the different chemotherapy regimens showed the lack of statistical significance correlations.CONCLUSIONS: Because of the lack of clinical trials in patients affected by these rare pancreatic histotypes, only their molecular classification would help clinicians in future therapeutic choice.
KW - Adenocarcinoma, Mucinous/drug therapy
KW - Aged
KW - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
KW - Carcinoma, Acinar Cell/drug therapy
KW - Carcinoma, Adenosquamous/drug therapy
KW - Carcinoma, Pancreatic Ductal/drug therapy
KW - Cystadenocarcinoma, Mucinous/drug therapy
KW - Humans
KW - Kaplan-Meier Estimate
KW - Middle Aged
KW - Pancreatic Neoplasms/drug therapy
KW - Prognosis
KW - Retrospective Studies
KW - Treatment Outcome
U2 - 10.1097/MPA.0000000000001063
DO - 10.1097/MPA.0000000000001063
M3 - Article
C2 - 29771769
VL - 47
SP - 759
EP - 771
JO - Pancreas
JF - Pancreas
SN - 0885-3177
IS - 6
ER -