Abstract
381 Background: The recent results of the phase III trial MPACT (Metastatic Pancreatic Adenocarcinoma Clinical Trial) demonstrated an improvement in progression free survival, overall response rate, and overall survival for the combination of nab-paclitaxel plus gemcitabine compared to gemcitabine alone. Methods: A retrospective analysis of patients with advanced pancreatic adenocarcinoma was undertaken to determine the disease control rate (CR+PR+SD ≥ 16 weeks) in patients who had received prior nab-paclitaxel plus gemcitabine and were retreated with nab-paclitaxel plus gemcitabine again after receiving other interval therapies. Results: Nine patients were identified. The median time between treatments of nab-paclitaxel plus gemcitabine was 7.67 months (range 2.53 to 54.03 months). The regimens used in between treatments of nab-paclitaxel plus gemcitabine were 5FU-based in 8 of the 9 patients, with the other patient undergoing temozolomide, cetuximab, and sorafenib sequential treatment. Five of the nine patients received repeat nab-paclitaxel plus gemcitabine > 6 months after their initial nab-paclitaxel/gemcitabine regimen and four of the nine received repeat nab-paclitaxel plus gemcitabine < 6 months after their initial nab-paclitaxel/gemcitabine regimen. The disease control rate seen for the second treatment with nab-paclitaxel plus gemcitabine was 44% (four of nine patients). Two of these patients received repeat nab-paclitaxel plus gemcitabine < 6 months after their first nab-paclitaxel plus gemcitabine regimen and two of these patients received repeat nab-paclitaxel plus gemcitabine > 6 months after their first nab-paclitaxel plus gemcitabine regimen. Three of nine patients (33%) had treatment a third time with nab-paclitaxel plus gemcitabine, with 2 of 3 of these patients having disease control. As of September 1st, 2013, two of nine patients are still undergoing repeat nab-paclitaxel plus gemcitabine therapy. Conclusions: Nab-paclitaxel plus gemcitabine can be an effective repeat regimen in patients with advanced pancreatic adenocarcinoma. In this very small series, the time between reinitiation of nab-paclitaxel plus gemcitabine appears to not play a role in disease control rate.
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