Three-month life expectancy as inclusion criterion for clinical trials in advanced pancreatic cancer: is it really a valid tool for patient selection?

Clin Transl Oncol. 2024 May;26(5):1268-1272. doi: 10.1007/s12094-023-03323-1. Epub 2023 Oct 4.

Abstract

Purpose: To analyze the 3-month life expectancy rate in pancreatic cancer (PC) patients treated within prospective trials from the German AIO study group.

Patients and methods: A pooled analysis was conducted for patients with advanced PC that were treated within five phase II/III studies conducted between 1997 and 2017 (Gem/Cis, Ro96, RC57, ACCEPT, RASH). The primary goal for the current report was to identify the actual 3-month survival rate, a standard inclusion criterion in oncology trials.

Results: Overall, 912 patients were included, 83% had metastatic and 17% locally advanced PC; the estimated median overall survival (OS) was 7.1 months. Twenty-one percent of the participants survived < 3 months, with a range from 26% in RC57 to 15% in RASH. Significant predictors for not reaching 3-month OS were > 1 previous treatment line (p < 0.001) and performance status (p < 0.001).

Conclusions: Despite the definition of a life expectancy of > 3 months as a standard inclusion criterion in clinical trials for advanced PC, a significant proportion of study patients does not survive > 3 months.

Trial registration numbers: NCT00440167 (AIO-PK0104), NCT01729481 (RASH), NCT01728818 (ACCEPT).

Keywords: Clinical trial; Inclusion criterion; Pancreatic cancer; Prognosis.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Deoxycytidine / therapeutic use
  • Gemcitabine*
  • Humans
  • Pancreatic Neoplasms*
  • Patient Selection
  • Prospective Studies

Substances

  • Gemcitabine
  • Deoxycytidine

Associated data

  • ClinicalTrials.gov/NCT01729481
  • ClinicalTrials.gov/NCT00440167
  • ClinicalTrials.gov/NCT01728818