The efficacy and toxicity of chemotherapy in the elderly with advanced pancreatic cancer.
OBJECTIVES
FOLFIRINOX (FFX) or abraxane plus gemcitabine (AG)-based chemotherapy is used widely as firstline treatment for patients with pancreatic cancer. However, their use in the elderly is discouraged because of adverse events. More clinical data about the therapeutic response and tolerability to FFX or AG in elderly patents (over 70 years old) are required.


METHODS
Patients with advanced pancreatic cancer (n = 203; 131 metastatic pancreatic cancer patients (MPC) and 72 locally advanced pancreatic cancer patients (LAPC)) were treated using modified-FFX (mFFX) or AG and mFFX sequentially. The patients were grouped according to their age, patients below 70 years old and patients above 70 years old. The objective response rate (ORR), disease control rate (DCR), progression free survival (PFS), overall survival (OS) and adverse events were compared between the groups.


RESULTS
The ORRs in the elderly and in patients below 70 were similar (30.0% versus 32.3%). The median OS and PFS were also similar between the groups (mOS 13.3 m vs 12.7 m, p = 0.729, HR 0.874 (95% CI 0.5310 to 1.438); mPFS mPFS 10.6 m vs 10.3 m, p = 0.363, HR 0.800 (95% CI 0.4954 to 1.293)). However, the elderly patients suffered a higher incidence of severe adverse events (50% vs. 28.3%).


CONCLUSIONS
These data could provide guidance for chemotherapy use in elderly patients with advanced pancreatic cancer. Age did not affect treatment outcome; however, supportive treatment is very important for elderly patients receiving chemotherapy.
['Li|Xiang|X|', 'Huang|Da-Bing|DB|', 'Zhang|Qi|Q|', 'Guo|Cheng-Xiang|CX|', 'Fu|Qi-Han|QH|', 'Zhang|Xiao-Chen|XC|', 'Tang|Tian-Yu|TY|', 'Su|Wei|W|', 'Chen|Yi-Wen|YW|', 'Chen|Wei|W|', 'Ma|Tao|T|', 'Gao|Shun-Liang|SL|', 'Que|Ri-Sheng|RS|', 'Bai|Xue-Li|XL|', 'Liang|Ting-Bo|TB|']
D000368:Aged D000369:Aged, 80 and over D000068196:Albumin-Bound Paclitaxel D000970:Antineoplastic Agents D000971:Antineoplastic Combined Chemotherapy Protocols D003841:Deoxycytidine D005472:Fluorouracil D006801:Humans D000077146:Irinotecan D002955:Leucovorin D000077150:Oxaliplatin D010190:Pancreatic Neoplasms
Chemotherapy Elderly Abraxane plus gemcitabine Tolerability Modified-FOLFIRINOX