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Chemotherapy-induced neutropenia as a prognostic factor in patients with pancreatic cancer treated with gemcitabine plus nab-paclitaxel: a retrospective cohort study

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Abstract

Objectives

Chemotherapy-induced neutropenia (CIN) is a common adverse event of chemotherapy. Several reports have suggested that CIN could be an important prognostic factor in chemotherapy of various cancers. However, whether CIN is a prognostic factor in unresectable pancreatic cancer (PC) treated with gemcitabine plus nab-paclitaxel (GnP) is unknown. The primary endpoint of this study was to compare overall survival (OS) between patients with severe CIN (grade ≥ 3) and those with absent/mild CIN (grade ≤ 2) in unresectable PC cases treated with GnP as first-line chemotherapy.

Methods

A retrospective, cohort study was conducted using data from a computerized database. A total of 290 patients with pathologically confirmed PC treated with GnP as first-line chemotherapy were analyzed (severe CIN: ≥ grade 3, n = 174; absent/mild CIN: ≤ grade 2, n = 116).

Results

The median OS was longer in the severe CIN group than in the absent/mild CIN group (19.2 months vs 11.3 months, respectively; P < 0.001). After adjustment, severe CIN was an independent predictive factor for OS (hazard ratio [HR], 0.53; 95% confidence interval [CI], 0.38–0.74; P < 0.001). After adjustment by time-varying covariates, severe CIN was still a significant prognostic factor for OS (HR, 0.79; 95% CI 0.69–0.91, P = 0.001).

Conclusion

The present results show that severe CIN is an independent and useful prognostic factor in PC patients treated with GnP.

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Acknowledgements

All authors had the opportunity to review the analysis plan and outcome, participated in the preparation of this report, and provided final approval. The corresponding author had full access to the data and takes final responsibility for the decision to submit this manuscript for publication.

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Authors and Affiliations

  1. Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, 277-8577, Japan

    Motoyasu Kan, Hiroshi Imaoka, Kazuo Watanabe, Mitsuhito Sasaki, Hideaki Takahashi, Yusuke Hashimoto, Izumi Ohno, Shuichi Mitsunaga, Kumiko Umemoto, Gen Kimura, Yuko Suzuki, Hiroki Eguchi, Toru Otsuru, Kyosuke Goda & Masafumi Ikeda

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  1. Motoyasu Kan
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Correspondence to Hiroshi Imaoka.

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Kan, M., Imaoka, H., Watanabe, K. et al. Chemotherapy-induced neutropenia as a prognostic factor in patients with pancreatic cancer treated with gemcitabine plus nab-paclitaxel: a retrospective cohort study. Cancer Chemother Pharmacol 86, 203–210 (2020). https://doi.org/10.1007/s00280-020-04110-3

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