Supplementary Material for: Retrospective Analysis of CA19-9 Decrease in Patients with Metastatic Pancreatic Carcinoma Treated with FOLFIRINOX or Gemcitabine in a Randomized Phase III Study (ACCORD11/PRODIGE4)

Objectives: Carbohydrate antigen 19-9 (CA19-9) is a
sensitive and specific serum marker in pancreatic cancer. Our
retrospective analysis aims to evaluate CA19-9 decrease in patients with
metastatic pancreatic cancer treated in ACCORD11/PRODIGE4 (FOLFIRINOX
vs. gemcitabine). Methods: A total of 342 patients were
treated. CA19-9 was measured at 8 weeks (±2) in 160 patients from a
total of 282 with abnormal CA19-9 values at baseline (gemcitabine arm, n = 75; FOLFIRINOX arm, n
= 85). In the present study, 8-week CA19-9 decrease or greater CA19-9
decrease according to the 20 and 90% thresholds were analyzed.
Progression-free survival (PFS) and overall survival (OS) were estimated
in each subgroup. Results: In the FOLFIRINOX arm,
patients with an 8-week CA19-9 decrease or greater CA19-9 decrease ≥20%
showed improved median OS, PFS, and objective response rate. In the
overall study population, median OS and PFS were significantly improved
in patients with an 8-week CA19-9 decrease ≥20% (vs. <20%). The
8-week CA19-9 decrease was predictive of PFS (interaction test
significant according to treatment arm; p = 0.006). Conclusion:
An 8-week CA19-9 decrease ≥20% is a prognostic factor for OS and PFS.
The 8-week CA19-9 decrease (20% threshold) is predictive of PFS. It
could help to evaluate the efficacy of FOLFIRINOX and gemcitabine
regimens.