Preprint Article Version 1 This version is not peer-reviewed

Severe neutropenia is associated with better clinical outcomes in patients with advanced pancreatic cancer who received modified FOLFIRINOX therapy

Version 1 : Received: 27 September 2018 / Approved: 27 September 2018 / Online: 27 September 2018 (10:12:08 CEST)

A peer-reviewed article of this Preprint also exists.

Yamada, Y.; Fujii, H.; Watanabe, D.; Kato-Hayashi, H.; Ohata, K.; Kobayashi, R.; Ishihara, T.; Uemura, S.; Iwashita, T.; Shimizu, M.; Suzuki, A. Severe Neutropenia is Associated with Better Clinical Outcomes in Patients with Advanced Pancreatic Cancer Who Receive Modified FOLFIRINOX Therapy. Cancers 2018, 10, 454. Yamada, Y.; Fujii, H.; Watanabe, D.; Kato-Hayashi, H.; Ohata, K.; Kobayashi, R.; Ishihara, T.; Uemura, S.; Iwashita, T.; Shimizu, M.; Suzuki, A. Severe Neutropenia is Associated with Better Clinical Outcomes in Patients with Advanced Pancreatic Cancer Who Receive Modified FOLFIRINOX Therapy. Cancers 2018, 10, 454.

Journal reference: Cancers 2018, 10, 454
DOI: 10.3390/cancers10110454

Abstract

Modified FOLFIRINOX is effective for advanced pancreatic cancer but frequently causes severe neutropenia. The present study was designed to investigate the influence of severe neutropenia on clinical outcomes in advanced pancreatic cancer patients receiving modified FOLFIRINOX. Fifty-one advanced pancreatic cancer patients who received modified FOLFIRINOX during January 2014 and May 2018 were subjects of the present study. Adverse events, including neutropenia, were graded according to the Common Terminology Criteria for Adverse Events, version 4.0. Median overall survival (OS) was determined as the primary endpoint, while median time to treatment failure (TTF), overall response rate (ORR), and the incidence of other adverse events were measured as secondary endpoints. Severe neutropenia (grade≥3) occurred in 39 patients (76.4%), in which high level of total bilirubin (>0.6mg/dL) was a significant risk as assessed by a multivariate logistic regression analysis. Median duration of OS was significantly longer in patients with severe neutropenia than in those without it (15.2 months versus 7.2 months, P=0.032). Moreover, there was a significant correlation between OS and the grade of neutropenia (R=0.306, P=0.029). ORR tended to be higher, though not significantly, in patients with severe neutropenia. In contrast, the incidence rates of other adverse events were not different between the two groups. Severe neutropenia is an independent predictor of prognosis in advanced pancreatic cancer patients received modified FOLFIRNOX therapy.

Subject Areas

Modified FOLFIRINOX; Severe neutropenia; Overall survival; Overall response rate; Time to treatment failure; Advanced pancreatic cancer

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