[Evaluation of therapeutic effect of chemotherapy with reference to clinical benefit response]

In chemotherapy (CHT) for solid tumors, improvement of symptoms may be clinically beneficial, even if objective tumor responses are not recognized. The vast majority of patients with advanced pancreatic cancer (PC) are symptomatic at diagnosis. In particular, severe pain and poor general condition can be major debilitating problems. In patients with such symptoms, optimal palliation of symptoms to maximization the quality of life is of primary importance. In recent years, such a clinical benefit response (CBR) has become a new treatment end-point being explored in clinical trials involving PC. The CBR is generally evaluated using two parameters in patients with PC: pain (intensity of pain and consumption of morphine) and Karnofsky performance status (KPS). A remarkable CBR was obtained in about 20-25% of patients treated with gemcitabine or combined CHT using fluorouracil and cisplatin (FP therapy). This new assessment method for CHT using CBR may be useful for evaluating chemotherapeutic response and may provide a strong rationale for continuing CHT in patients with stable disease according to imaging modalities.