Abstract
Background: Surgical resection following neoadjuvant nab-paclitaxel plus gemcitabine chemotherapy is one of the standard strategy for unresectable pancreatic cancer. This study was undertaken to retrospectively evaluate real world non-trial outcomes with this combination chemotherapy followed by surgery for unresectable pancreatic cancer. Material & Methods: Patients with clinically diagnosed advanced unresectable pancreatic cancer, treated with nab-paclitaxel plus gemcitabine combination chemotherapy between January 2014 and November 2018 in our hospital, were retrospectively analyzed. Results: A total of 51 patients were treated with the combination chemotherapy. The mean age of 51 patients was 69.7 years old, and the ratio of male to female was 28: 23. Of these, 33.3% of patients were recurrent disease after surgery. In terms of adverse event, hair loss was seen in almost all cases. Other adverse events were myelosuppression in 16 cases (31.3%) and peripheral neuropathies in 23 cases (45.1%). We also found febrile neutropenia in 4 cases (7.8%) and interstitial pneumonia in 2 cases (3.9%). Surgical resection after combination chemotherapy was performed in 5 cases (9.8%). All 5 cases were male and the average age was 68.6 years old. In cases where surgical resection became capable after chemotherapy, 2 cases were unresectable pancreatic cancer due to liver metastasis and 3 cases were locally advanced pancreatic cancer. The number of cycles of vhemotherapy was 4.8 cycles on average (2-6 cycles). In all cases, there were some adverse events, 3 cases with myelosuppression (60%), 3 cases with peripheral neuropathy (60%). Finally the objective response rate of this combination chemotherapy was 29.4% and the disease control rate was 41.1%. Conclusion: Neoadjuvant nab-paclitaxel plus Gemcitabine combination chemotherapy was well-tolerated and effective in patients with unresectable pancreatic cancer, suggesting its feasibility as chemotherapy considering surgical resection.
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