Gemcitabine-Capecitabine Chemotherapy Plus Intra-Arterial Epirubicin-Cisplatin in Pancreatic Cancer Patients after FOLFIRINOX First Line Chemotherapy : A Retrospective Analysis

Background: Most pancreatic cancer patients have disease recurrence/progression within 6 months from firstline chemotherapy end. Today, there is no a standard of care of second-line therapy. Materials (patients) and methods: We retrospectively collected data of 41 locally advanced/metastatic pancreatic cancer patients underwent to FOLFIRINOX first line chemotherapy and subsequently treated with Gemcitabine-Capecitabine chemotherapy plus Intraarterial Epirubicin-Cispatin (EC-GEMCAP). Results: Treatment was well tolerated, without dose reductions or delays. Hematologic and no hematologic grade 3-4 toxicities were 39% and 12.2%. Twenty, 2 and 12 patients obtained a stability/partial response/progression disease respectively, with a disease control rate in 22 patients. One patient with locally advanced disease underwent to radically surgery after 6 cycles of EC-GEMCAP. Median OS was 16.9 months (95% CI: 14.7-19.0) with OS rates at 6, 12 and 24 months of 95.1%, 80.5% and 31.7%. As regards second-line therapy, median OS was 8.9 months (95% CI: 6.9-10.9). OS rates at 6, 12 and 24 months were 61%, 80.5% and 31.7%. EC-GEMCAP median PFS was 4.1 months (95% CI: 3.1-5.1). PFS rates at 6 and 12 months were 41.5% and 19.5%. Conclusions: EC-GEMCAP proved to be a viable treatment in terms of toxicity and activity and it could be considered a therapeutic option also in poor performance status patients. Citation: Ginocchi L, Valsuani C, Sara L, Ceccherini C, Pedata M, et al. Gemcitabine-Capecitabine Chemotherapy Plus Intra-Arterial EpirubicinCisplatin in Pancreatic Cancer Patients after FOLFIRINOX First Line Chemotherapy: A Retrospective Analysis. J Cancer Sci. 2016;3(1): 5. J Cancer Sci 3(1): 5 (2016) Page 02 ISSN: 2377-9292 status ≤2 and adequate organ function (leukocyte count >3500/μL, haemoglobin ≥10.0 g/dL, serum creatinine <1.25 times upper limit of normal (ULN), transaminases and alkaline phosphatase <2.5 times ULN, bilirubin <1.5 times ULN). Staging included abdominal sonography, total abdomen and chest CT scan. Weight, performance status, CA 19-9 levels, and side effects were evaluated at study entry and after each cycle of regional therapy. An abdomen and chest CT scan was repeated every 3 treatment cycles. All patients gave their informed consent according to our institutional guidelines.