Second-line therapy after nab-paclitaxel plus gemcitabine or after gemcitabine for patients with metastatic pancreatic cancer

E. Gabriela Chiorean, Daniel D. Von Hoff, Josep Tabernero, Robert El-Maraghi, Wen Wee Ma, Michele Reni, Marion Harris, Robert Whorf, Helen Liu, Jack Shiansong Li, Victoria Manax, Alfredo Romano, Brian Lu, David Goldstein

Research output: Contribution to journalArticle

44 Scopus citations

Abstract

Background: This exploratory analysis evaluated second-line (2L) therapy for metastatic pancreatic cancer in a large phase 3 trial (MPACT). Methods: Patients who received first-line (1L) nab-paclitaxel+gemcitabine (nab-P+Gem) or Gem were assessed for survival based on 2L treatment received. Multivariate analyses tested influence of treatment effect and prognostic factors on survival. Results: The majority of 2L treatments (267 out of 347, 77%) contained a fluoropyrimidine (5-fluorouracil or capecitabine). Median total survival (1L randomisation to death) for patients who received 2L treatment after 1L nab-P+Gem vs Gem alone was 12.8 vs 9.9 months (P=0.015). Median total survival for patients with a fluoropyrimidine-containing 2L therapy after nab-P+Gem vs Gem was 13.5 vs 9.5 months (P=0.012). Median 2L survival (duration from start of 2L therapy to death) was 5.3 vs 4.5 months for nab-P+Gem vs Gem, respectively (P=0.886). Factors significantly associated with longer post-1L survival by multivariate analyses included 1L nab-P+Gem, receiving 2L treatment, longer 1L progression-free survival, and Karnofsky performance status≥70 and neutrophil-to-lymphocyte ratio≤5 at the end of 1L treatment. Conclusions: These findings support the use of 2L therapy for patients with metastatic pancreatic cancer. Fluoropyrimidine-containing treatment after 1L nab-P+Gem is an active regimen with significant clinical effect.

Original languageEnglish (US)
Pages (from-to)188-194
Number of pages7
JournalBritish journal of cancer
Volume115
Issue number2
DOIs
StatePublished - Jul 12 2016

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Chiorean, E. G., Von Hoff, D. D., Tabernero, J., El-Maraghi, R., Ma, W. W., Reni, M., Harris, M., Whorf, R., Liu, H., Li, J. S., Manax, V., Romano, A., Lu, B., & Goldstein, D. (2016). Second-line therapy after nab-paclitaxel plus gemcitabine or after gemcitabine for patients with metastatic pancreatic cancer. British journal of cancer, 115(2), 188-194. https://doi.org/10.1038/bjc.2016.185