RT Journal Article
T1 Prognostic factors for survival with nab-paclitaxel plus gemcitabine in metastatic pancreatic cancer in real-life practice: the ANICE-PaC study.
A1 Fernández, Ana
A1 Salgado, Mercedes
A1 García, Adelaida
A1 Buxò, Elvira
A1 Vera, Ruth
A1 Adeva, Jorge
A1 Jiménez-Fonseca, Paula
A1 Quintero, Guillermo
A1 Llorca, Cristina
A1 Cañabate, Mamen
A1 López, Luis Jesús
A1 Muñoz, Andrés
A1 Ramírez, Patricia
A1 González, Paula
A1 López, Carlos
A1 Reboredo, Margarita
A1 Gallardo, Elena
A1 Sanchez-Cánovas, Manuel
A1 Gallego, Javier
A1 Guillén, Carmen
A1 Ruiz-Miravet, Nuria
A1 Navarro-Pérez, Víctor
A1 De la Cámara, Juan
A1 Alés-Díaz, Inmaculada
A1 Pazo-Cid, Roberto Antonio
A1 Carmona-Bayonas, Alberto
K1 First-line chemotherapy
K1 Gemcitabine
K1 Metastatic pancreatic adenocarcinoma
K1 Nab-paclitaxel
K1 Real-life
K1 Survival
AB 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.
YR 2018
FD 2018-11-29
LK http://hdl.handle.net/10668/13261
UL http://hdl.handle.net/10668/13261
LA en
DS RISalud
RD Apr 5, 2025