Pancreatic cancer treatment after FOLFIRINOX: prognostic importance of chemotherapy dose intensity and albumin/globulin ratio in second line

Abstract

Aim: Pancreatic adenocarcinoma (PA) is the seventh most common cause of cancer-related mortality. Our primary endpoint of study was to determine the relationship between albumin/globulin ratio (AGR) and progression-free and overall survival (PFS and OS) in second-line treatment after FOLFIRINOX. Our secondary endpoint was to assess treatment side effects and the relationship of treatment dose intensity with treatment type and AGR. Material and Method: PA patients who followed-up between January 2014 and January 2021 were evaluated retrospectively. Age, gender, ECOG score and AGR recorded at the beginning of the second-line treatment. Thrombocytopenia, neutropenia, chemotherapy type, chemotherapy dose intensity, PFS and OS were recorded during the second-line treatment. Results: Median age 64 (44-80), 72 (70.6%) male, 102 metastatic PA patients were evaluated. 76 (74.5%) patients were ECOG 0-1, 26 (25.5%) patients were ECOG 2. Of these patients in the second step, 68 (66.7%) received single-agent gemcitabine and 34 (33.3%) received Nab-paclitaxel + gemcitabine treatment. Progression and exitus events occurred in all cases. Median PFS was 166.8 days in the AGR>1.2 group, it was 80.7 days in the AGR1.2 group, it was 144 days in the AGR1.2 group, it was 71.3% in the AGR