A modified regimen of biweekly gemcitabine and nab-paclitaxel in patients with metastatic pancreatic cancer is both tolerable and effective: A retrospective analysis

Daniel H. Ahn, Kavya Krishna, Marlo Blazer, Joshua Reardon, Lai Wei, Christina Wu, Kristen K. Ciombor, Anne M. Noonan, Sameh Mikhail, Tanios Bekaii-Saab

Research output: Contribution to journalArticle

25 Scopus citations

Abstract

Background: Treatment with nab-paclitaxel with gemcitabine demonstrates a survival advantage when compared with single-agent gemcitabine. However, the combination is associated with significant toxicities, leading to a high rate of drug discontinuation. We implemented a modified regimen of gemcitabine and nab-paclitaxel (mGNabP) in an attempt to minimize toxicities while maintaining efficacy. Methods: A total of 79 evaluable patients with metastatic pancreatic adenocarcinoma (mPC) treated with a modified regimen of gemcitabine (1000 mg/m2) and nab-paclitaxel (125 mg/m2) on days 1, 15 of every 28-day cycle were identified from our prospective database. A total of 57 patients received this regimen as first-line treatment and were evaluated for toxicities, progression-free survival (PFS), and overall survival (OS). Overall, 22 patients with advanced or metastatic PC treated with the modified regimen outside the first-line setting were only evaluated for toxicities. Results: The median OS and PFS were 10 months [95% confidence interval (CI) 5.9-13 months] and 5.4 months (95% CI 4.1-7.4 months) for patients that received the modified regimen as first-line therapy. Neurotoxicity occurred in 27% with only 1.6% of patients experiencing grade 3/43 toxicity. The incidence of grade 3/43 neutropenia was 19%, resulting in growth factor support in 12% of patients. This rate was similar in patients who received the modified regimen for first-line treatment of mPC versus the overall group. Conclusions: A modified regimen of biweekly nab-paclitaxel with gemcitabine is associated with a lower cost, acceptable toxicity profile and appears to be relatively effective in pancreatic cancer. Prospective randomized studies confirming its potential benefits compared with standard weekly mGNabP are warranted.

Original languageEnglish (US)
Pages (from-to)75-82
Number of pages8
JournalTherapeutic Advances in Medical Oncology
Volume9
Issue number2
DOIs
StatePublished - Feb 1 2017

Keywords

  • efficacious
  • gemcitabine-improved toxicity
  • modified regimen
  • nab-paclitaxel
  • pancreatic cancer

ASJC Scopus subject areas

  • Oncology

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