%0 Journal Article
%A Fernández, Ana
%A Salgado, Mercedes
%A García, Adelaida
%A Buxò, Elvira
%A Vera, Ruth
%A Adeva, Jorge
%A Jiménez-Fonseca, Paula
%A Quintero, Guillermo
%A Llorca, Cristina
%A Cañabate, Mamen
%A López, Luis Jesús
%A Muñoz, Andrés
%A Ramírez, Patricia
%A González, Paula
%A López, Carlos
%A Reboredo, Margarita
%A Gallardo, Elena
%A Sanchez-Cánovas, Manuel
%A Gallego, Javier
%A Guillén, Carmen
%A Ruiz-Miravet, Nuria
%A Navarro-Pérez, Víctor
%A De la Cámara, Juan
%A Alés-Díaz, Inmaculada
%A Pazo-Cid, Roberto Antonio
%A Carmona-Bayonas, Alberto
%T Prognostic factors for survival with nab-paclitaxel plus gemcitabine in metastatic pancreatic cancer in real-life practice: the ANICE-PaC study.
%D 2018
%U http://hdl.handle.net/10668/13261
%X Treatment with nab-paclitaxel plus gemcitabine increases survival in patients with metastatic pancreatic cancer. However, the assessment of treatment efficacy and safety in non-selected patients in a real-life setting may provide useful information to support decision-making processes in routine practice. Retrospective, multicenter study including patients with metastatic pancreatic cancer, who started first-line treatment with nab-paclitaxel plus gemcitabine between December 2013 and June 2015 according to routine clinical practice. In addition to describing the treatment pattern, overall survival (OS) and progression-free survival (PFS) were assessed for the total sample and the exploratory subgroups based on the treatment and patients' clinical characteristics. All 210 eligible patients had a median age of 65.0 years (range 37-81). Metastatic pancreatic adenocarcinoma was recurrent in 46 (21.9%) patients and de novo in 164 (78.1%); 38 (18%) patients had a biliary stent. At baseline, 33 (18.1%) patients had an ECOG performance status ≥2. Patients received a median of four cycles of treatment (range 1-21), with a median duration of 3.5 months; 137 (65.2%) patients had a dose reduction of nab-paclitaxel and/or gemcitabine during treatment, and 33 (17.2%) discontinued treatment due to toxicity. Relative dose intensity (RDI) for nab-paclitaxel, gemcitabine, and the combined treatment was 66.7%. Median OS was 7.2 months (95% CI 6.0-8.5), and median PFS was 5.0 months (95% CI 4.3-5.9); 50 patients achieved either a partial or complete response (ORR 24.6%). OS was influenced by baseline ECOG PS, NLR and CA 19.9, but not by age ≥ 70 years and/or the presence of hepatobiliary stent or RDI  3 vs. ≤ 3 (p = 0.043), and baseline CA 19.9 > 37 U/mL vs. ≤37 U/mL (p = 0.004). Nab-Paclitaxel plus gemcitabine remain effective in a real-life setting, despite the high burden of dose reductions and poorer performance of these patients. A nomogram to predict survival using baseline ECOG performance status, NLR and CA 19.9 is proposed.
%K First-line chemotherapy
%K Gemcitabine
%K Metastatic pancreatic adenocarcinoma
%K Nab-paclitaxel
%K Real-life
%K Survival
%~