Efficacy of Nab-Paclitaxel Plus Gemcitabine and Prognostic Value of Peripheral Neuropathy in Patients with Metastatic Pancreatic Cancer.
- Author:
Min Su YOU
1
;
Ji Kon RYU
;
Young Hoon CHOI
;
Jin Ho CHOI
;
Gunn HUH
;
Woo Hyun PAIK
;
Sang Hyub LEE
;
Yong Tae KIM
Author Information
- Publication Type:Original Article
- Keywords: Pancreatic neoplasm; Metastasis; Chemotherapy; Gemcitabine; Nab-paclitaxel
- MeSH: Disease-Free Survival; Drug Therapy; Drug Therapy, Combination; Follow-Up Studies; Humans; Linear Models; Methods; Neoplasm Metastasis; Pancreatic Neoplasms*; Peripheral Nervous System Diseases*
- From:Gut and Liver 2018;12(6):728-735
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: The combination of nab-paclitaxel and gemcitabine (nab-P/Gem) is widely used for treating meta-static pancreatic cancer (MPC). We aimed to evaluate the therapeutic outcomes and prognostic role of treatment-related peripheral neuropathy in patients with MPC treated with nab-P/Gem in clinical practice. METHODS: MPC patients treated with nab-P/Gem as the first-line chemotherapy were included. All 88 Korean patients underwent at least two cycles of nab-P/Gem combination chemotherapy (125 and 1,000 mg/m2, respectively). Treatment-related adverse events were monitored through periodic follow-ups. Overall survival and progression-free survival were estimated by the Kaplan Meier method, and the Cox proportional hazards regression linear model was applied to assess prognostic factors. To evaluate the prognostic value of treatment-related peripheral neuropathy, the landmark point analysis was used. RESULTS: Patients underwent a mean of 6.7±4.2 cycles during 6.3±4.4 months. The median overall survival and progression-free survival rates were 14.2 months (95% confidence interval [CI], 11.8 to 20.3 months) and 8.4 months (95% CI, 7.1 to 13.2 months), respectively. The disease control rate was 84.1%; a partial response and stable disease were achieved in 30 (34.1%) and 44 (50.0%) patients, respectively. Treatment-related peripheral neuropathy developed in 52 patients (59.1%), and 13 (14.8%) and 16 (18.2%) patients experienced grades 2 and 3 neuropathy, respectively. In the landmark model, at 6 months, treatment-related peripheral neuropathy did not have a significant correlation with survival (p=0.089). CONCLUSIONS: Nab-P/Gem is a reasonable choice for treating MPC, as it shows a considerable disease control rate while the treatment-related peripheral neuropathy was tolerable. The prognostic role of treatment-related neuropathy was limited.
