Nab-paclitaxel plus gemcitabine in the treatment of metastatic pancreatic cancer: our experience

Abstract

Background: Pancreatic cancer (PA) is the fourth most fatal cancer for both man and women. Many of patients(pts) with metastatic disease are often not included in clinical trials due to comorbidity such as diabetes, jaundice, etc.and poor performance status at diagnosis. These patients are the most treat in our clinical practice and they have few opportunities for cure. Von Hoff D. et all. (2013) published the data of the phase III MPACT study showing a statistically significant benefit of the nab-paclitaxel plus gemcitabine vs gemcitabine alone in terms of OS (8,5 vs 6,7 months) and PFS(5,5 vs 3,7months) as first line treatment for metastatic disease with acceptable toxicity. Materials and methods: From September 2015 to May 2017 we collected the data of 26 unselected metastatic pancreatic cancer pts treated with nab-paclitaxel 125mg/mq and gemcitabine 1g/mq on days 1,8,15 q 28 days cycle, as first line treatment. Median age was 64 year (range 46-78); 9pts (34%) were over 70 years old. 9pts(34%) were male and 17(65%) female. PS 0: 10pts(38%), PS1:10pts(38%), PS2:6pts(23%). NLR was > 5 in 6pts(23%). They received a median of 15 drug administrations (range 1-32). Results: The treatment was well tolerated. No toxic death or grade 4toxicity were recordedHematologic G3 toxicity included: Neutropenia 4pts (15%), Thrombocytopenia 4pts(15%). Non Hematologic G3 toxicity included: Neuropathy 1pts (3%), Asthenia 2pts (7%). ORR was 38%(10/26), DCR(PR+SD) was 53%(14/26), median PFS was 6 months (range 1-12), median OS was 9 months (range 2-18). 38%(10/26) of pts received a second line treatment. Conclusion: We believe that nab–paclitaxel plus gemcitabine is an active and discreetly tolerated schedule and that the literature data can be reproduced in clinical practice in unselected pts with metastatic disease.