Predictive factors for tumor response to chemotherapy in patients with pancreatic cancer

Systemic chemotherapy for pancreatic adenocarcinoma, at present, has been of limited value in clinical practice and only a small portion of patients obtains meaningful palliation.

We retrospectively examined 96 patients with metastatic pancreatic adenocarcinoma undergoing systemic chemotherapy to determine factors predictive of tumor response. None of the patients had received any prior anti-cancer treatment except for pancreatectomy.

Of these 96 patients, 5 patients (5.2%) showed partial response but none showed complete response. There was no responder with a performance status of 2 or 3, serum albumin level less than 3.5 g/dL, serum total bilirubin level equal to or more than 2.0 mg/dL, or peritoneal dissemination. Response rates tended to be higher in the subgroups of female patients, those with serum albumin level > or = 3.5 g/dL and those with serum carcinoembryonic antigen level < 10 ng/mL, although there were no significant differences.

Patients with a poor performance status, hypoalbuminemia, jaundice, or peritoneal dissemination might be inappropriate candidates for systemic chemotherapy and might be treated with other experimental approaches or supportive care.