Effectiveness and safety of nab-paclitaxel/gemcitabine in locally advanced or metastatic pancreatic adenocarcinoma

• Published in: Journal of oncology pharmacy practice 2020-04, Vol.26 (3), p.603-611
• Main Authors: Nebot-Villacampa, María-José, Zafra-Morales, Ricardo, Alfaro-Olea, Ascensión, Marín-Gorricho, Raquel, Casajús-Navasal, Andrea, Uriarte-Pinto, Moisés
• Format: Article
• Language: English
• Subjects: Adenocarcinoma; Clinical trials; Gemcitabine; Lymphocytes; Metastases; Metastasis; Neuralgia; Paclitaxel; Pancreas; Pancreatic cancer; Patients; Safety; Toxicity
• ISSN: 1078-1552; 1477-092X
• DOI: 10.1177/1078155219862035

Background Treatment based on nab-paclitaxel plus gemcitabine is one of the standard treatments for locally advanced or metastatic pancreatic adenocarcinoma. Not much information is available about its use in clinical practice. Looking for prognostic markers may aid in improving treatment plans for patients. Objective To describe the effectiveness and safety profile of nab-paclitaxel/gemcitabine in locally advanced or metastatic pancreatic adenocarcinoma. We also tried to evaluate prognostic markers of response to treatment. Setting Retrospective descriptive study carried out in a tertiary hospital of Spain. Method Patients with locally advanced or metastatic pancreatic adenocarcinoma treated with nab-paclitaxel/gemcitabina between January 2014 and December 2017 were included in the analyses. Main outcome measure Effectiveness was measured in terms of overall survival, progression-free survival and response rate. To evaluate the safety profile, every adverse event from the start of the treatment and up to 10 days after its completion was registered. Results Fifty patients were included. Thirty-three (66%) had metastatic disease. Median overall survival was 8.8 months (95%CI: 5.1–12.5) and the median progression-free survival was 5.6 months (95%CI: 4.3–6.9). Relevance of carbohydrate antigen 19-9 baseline levels as prognostic response marker was confirmed, while neutrophil-to-lymphocyte ratio did not show conclusive results for overall survival. Safety profile was similar to that observed in clinical trials, with a single case of treatment discontinuation due to grade 3 neuropathy. Conclusion The studied schedule for locally advanced or metastatic pancreatic adenocarcinoma seems to be an effective therapeutic option, with an easy to manage toxicity profile, similar to other schedules used in pancreatic adenocarcinoma.