title: Short time to progression under first-line chemotherapy is a negative prognostic factor for time to progression and residual survival under second-line chemotherapy in advanced pancreatic cancer.
abstract: OBJECTIVE
  Second-line chemotherapy is widely used in advanced pancreatic cancer. However, only few data exist concerning the question who might benefit from second-line therapy. We intended to identify prognostic factors for time to second progression (TTP2) and residual survival following second-line chemotherapy of patients with advanced pancreatic cancer.
  
  
  METHODS
  We performed a retrospective cohort study on 78 patients who started palliative chemotherapy at our department from January 2004 to June 2006 due to advanced adenocarcinoma of the pancreas. 46 patients who progressed following first-line therapy were analyzed.
  
  
  RESULTS
  In multivariate analyses, time to first progression (TTP1) <6 months and elevated LDH at the time of diagnosis were shown to be strong and highly significant independent prognostic factors for TTP2 and residual survival. For patients with TTP1 <6 months, prognosis was poor with a median residual survival of 4.4 versus 7.5 months for those with TTP1 > or =6 months.
  
  
  CONCLUSIONS
  In our cohort of patients with advanced pancreatic cancer treated with second-line chemotherapy, TTP1 <6 months is a strong negative prognostic factor for TTP2 and residual survival.
authors.affiliation: Department of Medical Oncology, National Center for Tumor Diseases, University of Heidelberg, Heidelberg, Germany.
authors.forename: Christina
authors.initials: C
authors.lastname: Herrmann
authors.forename: Ulrich
authors.initials: U
authors.lastname: Abel
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Stremmel
authors.forename: Dirk
authors.initials: D
authors.lastname: Jaeger
authors.forename: Thomas
authors.initials: T
authors.lastname: Herrmann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000069287:Capecitabine; D015331:Cohort Studies; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D018450:Disease Progression; D004334:Drug Administration Schedule; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000627:therapeutic use; D000077150:Oxaliplatin; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D011379:Prognosis; D015996:Survival Rate; D013997:Time Factors; D000093542:Gemcitabine
chemical_list: D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil; D000093542:Gemcitabine