The effectiveness of nab-paclitaxel plus gemcitabine and gemcitabine monotherapy in first-line metastatic pancreatic cancer treatment: A real-world evidence

Scientific paper - Original scientific paper

• Author: Juraj Prejac
• Author: Dora Tomek Hamzić
• Author: Nikša Librenjak
• Author: Irma Goršić
• Author: Domina Kekez
• Author: Stjepko Pleština
• Author's institution: University of Zagreb; School of Medicine; (Department of Pathophysiology)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Pathophysiology

Abstract (english)

Pancreatic cancer is one of the most lethal malignancies with a rise in mortality rates. FOLFIRINOX and nab-paclitaxel plus gemcitabine demonstrated a survival benefit compared to gemcitabine alone. Both protocols are now considered the standard of first-line treatment with no significant difference between them, primarily based on observational studies. Although new therapeutic options have emerged recently, the prognosis remains poor. We conducted a retrospective single-center study on 139 patients treated for metastatic pancreatic adenocarcinoma (mPDAC) with gemcitabine monotherapy (Gem) or nab-paclitaxel + gemcitabine (Nab-P/Gem) in the first line. The aim of our study was to evaluate the effectiveness in terms of overall survival (OS) and progression-free survival (PFS) as well as the influence of patient and disease characteristics on outcomes. Nab-P/Gem resulted in OS of 13.87 months compared to 8.5 months in patients receiving Gem. The same trend was achieved in PFS, 5.37 versus 2.80 months, respectively, but without reaching statistical significance. Furthermore, the 6-month survival in the Nab-P/Gem group was also higher, 78.1% versus 47.8%. In terms of survival, the group of elderly patients, patients of poorer performance, with higher metastatic burden and liver involvement, benefited the most from combination therapy. In our analysis ECOG performance status (p.s.), previous primary tumor surgery, and liver involvement were found to be independent prognostic factors. The addition of nab-paclitaxel to gemcitabine resulted in a significant improvement in the OS of patients with mPDAC. Subgroup analysis demonstrated that patients with some unfavorable prognostic factors benefited the most.

• Keywords (english): Adenocarcinoma / pathology; Aged; Albumins; Antineoplastic Combined Chemotherapy Protocols; Deoxycytidine / analogs & derivatives; Gemcitabine; Humans; Paclitaxel; Pancreatic Neoplasms / pathology; Retrospective Studies; Treatment Outcome
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Medicine
• Numbering: vol. 101, no. 39, e30566
• e-ISSN: 1536-5964
• DOI: https://doi.org/10.1097/MD.0000000000030566
• URN:NBN: urn:nbn:hr:105:002851
• Publication: 2022-09-30
• Document URL: https://journals.lww.com/10.1097/MD.0000000000030566
• Type of resource: Text
• Access conditions: Open access
• Created on: 2023-08-28 07:04:15