Association of gemcitabine (GEM) efficacy on unresectable invasive pancreatic carcinoma with intraductal papillary mucinous neoplasms.

Abstract

478 Background: Invasive pancreatic carcinoma associated with intraductal papillary mucinous neoplasms (IC-IPMN) has showed more favorable prognosis than invasive pancreatic ductal carcinoma (IPDC) following surgical resection in some studies. IC-IPMN differs from IPDC in clinical manifestation and biology profile and is mostly surgically resectable in initial presentation. Chemotherapeutic effect on unresectable IC-IPMN is not described in the literature yet. Methods: Our pancreatic cancer database was reviewed to identify 43 patients with IC-IPMN between 2006-2013. IC-IPMN was determined with surgical pathology or with radiological diagnosis and biopsy evidence of adenocarcinoma. Of 43 patients, 14 unresectable IC-IPMN patients received GEM as first-line chemotherapy regimen. We investigated GEM efficacy, Overall Survival (OS), Progression Free Survival (PFS) and 1-year survival rate. Results: Characteristic baseline included gender (male: 9, female: 5), age (median: 73 years old), ECOG performance status (0-1, 92%), location (head 7, body/tail 6, diffuse 1), prior surgical resection (8), biliary intervention (5), metastasis (11), CRP (median: 0.15mg/dl, 0.1-1.0), CA19-9 (median: 29U/ml, 8-20820), CEA (median: 3.1ng/ml, 0.1-237). Median OS, PFS and 1-year survival rate were 24.0 months, 8.0 months and 86%. Gemcitabine therapy demonstrated 14% (2/14) response rate and 79% (11/14) disease control rate. Conclusions: UnresectableIC-IPMN indicates favorable survival and fair response to GEM in our study. Limitations are retrospective study at single center and small population due to its disease rarity.