Background Pancreatic cancer remains a fatal and difficult to-treat disease. Gemcitabine (G) is a cytotoxic agent that is potent against pancreatic adenocarcinoma. Nab-paclitaxel (nab-P), an albumin-bound formulation of paclitaxel, appears to decrease levels of cytidine deaminase, which is the primary gemcitabine catabolic enzyme. This probably increases sensitivity to G when these agents are combined.
Purpose To evaluate the effectiveness of G plus nab-P in patients with metastatic pancreatic ductal adenocarcinoma (PDA), as well as to compare results with the pivotal trial.
Materials and methods Retrospective observational study from January 2011–October 2012. The inclusion criteria were all patients with PDA who received 100 mg/m2 nab-P followed by G 1,000 mg/m2, administered intravenously on days 1, 8, and 15, every 28 days. The information was extracted from patients’ medical records and from pharmacy service records. Treatment was continued until disease progression or unacceptable toxicity. Variables: demographics, previous treatment and duration of treatment. Response to treatment was assessed using Response Evaluation Criteria in Solid Tumours (RECIST) parameters. Disease control rate was defined as the percentage of patients with complete and partial response and stable disease.
Results Eighteen patients with PDA were identified (61% males). The median age was 63 (range 41–80) years. Site of metastasic disease: liver (33%), bone (33%), abdomen/peritoneal (28%), lung (17%) and liver only (11%). Five patients had previous treatment: GEM and oxaliplatin (3), GEM and erlotinib (1), GEM monotherapy (1). The median duration of treatment was 3.5 cycles (range 1–12). Two patients were not assessed for response due to early clinical progression and poor tolerance. Only one complete response to treatment was obtained, while four patients achieved stable disease and five partial response. Six patients experienced disease progression. At 12 months, the survival rate was 35% (6 patients).
Conclusions Similar results in relation with one year overall survival were shown in the pivotal trial. It is important to highlight that the disease control rate was 56%.
No conflict of interest.
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