RESUMO
BACKGROUND: Chemotherapy for metastatic pancreatic adenocarcinoma (PDAC) primarily relies on FOLFIRINOX (LV5FU- irinotecan - Oxaliplatine) and Gemcitabine - Nab-Paclitaxel in the first-line setting. However, second-lines remain less well-defined and there is limited data regarding third-line treatments. The objective of our study was to determine the proportion of patients advancing to third line chemotherapy, to outline the various third-line chemotherapy regimens used in routine practice and to evaluate their respective efficacy. METHODS: A retrospective single-center cohort from 2010-2022 compiled baseline characteristics, treatment outcomes and survival of PDAC patients who received at least one chemotherapy line in a French tertiary-center. Overall survivals (OS) were analyzed using a Cox multivariable model. RESULTS: In total, 676 patients were included, with a median follow-up time of 69.4 months, (Interquartile Range (IQR) = 72.1). Of these, 251 patients (37%) that proceeded to 3rd-line chemotherapy. The median PFS in 3rd line was 2.03 months, [CI95%: 1.83, 2.36]. The median 3rd line overall survival was 5.5 months, [CI95%: 4.8, 6.3]. In multivariable analysis erlotinib-based chemotherapy was found to be deleterious (HR=2.38, [CI95%: 1.30, 4.34], p=0.005) compared to fluoropyrimidine-based chemotherapy in terms of 3rd line overall survival while gemcitabine monotherapy showed a tendency towards negative outcomes. First and 2nd line chemotherapies sequence didn't influence 3rd line outcome. CONCLUSION: In our cohort, one-third of treated patients proceeded to 3rd line chemotherapy resulting in a 5.5 months median 3rd line OS, consistent with treatments at advanced stage. Our results argue against the use of erlotinib and gemcitabine monotherapy.
Assuntos
Adenocarcinoma , Neoplasias Pancreáticas , Humanos , Neoplasias Pancreáticas/patologia , Gencitabina , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Estudos Retrospectivos , Cloridrato de Erlotinib/uso terapêutico , Adenocarcinoma/patologia , Desoxicitidina , Fluoruracila , Leucovorina/uso terapêutico , Paclitaxel , AlbuminasRESUMO
The present study reports the characterization of Ls-Stylicin1, a novel antimicrobial peptide from the penaeid shrimp, Litopenaeus stylirostris. The predicted mature peptide of 82 residues is negatively charged (theoretical pI=5.0) and characterized by a proline-rich N-terminal region and a C-terminal region containing 13 cysteine residues. The recombinant Ls-Stylicin1 has been isolated in both monomeric and dimeric forms. Both display strong antifungal activity against Fusarium oxysporum (1.25 microMAssuntos
Peptídeos Catiônicos Antimicrobianos/farmacologia
, Penaeidae/metabolismo
, Sequência de Aminoácidos
, Animais
, Peptídeos Catiônicos Antimicrobianos/química
, Peptídeos Catiônicos Antimicrobianos/genética
, Sequência de Bases
, Bioensaio
, DNA Complementar/genética
, Eletroforese em Gel de Poliacrilamida
, Hemócitos/citologia
, Hemócitos/efeitos dos fármacos
, Hemócitos/metabolismo
, Testes de Sensibilidade Microbiana
, Dados de Sequência Molecular
, Oceano Pacífico
, Ligação Proteica/efeitos dos fármacos
, Transporte Proteico/efeitos dos fármacos
, Proteínas Recombinantes/metabolismo
, Alinhamento de Sequência
, Análise de Sequência de DNA
, Vibrio/efeitos dos fármacos
, Vibrio/metabolismo