Fernández, AnaSalgado, MercedesGarcía, AdelaidaBuxò, ElviraVera, RuthAdeva, JorgeJiménez-Fonseca, PaulaQuintero, GuillermoLlorca, CristinaCañabate, MamenLópez, Luis JesúsMuñoz, AndrésRamírez, PatriciaGonzález, PaulaLópez, CarlosReboredo, MargaritaGallardo, ElenaSanchez-Cánovas, ManuelGallego, JavierGuillén, CarmenRuiz-Miravet, NuriaNavarro-Pérez, VíctorDe la Cámara, JuanAlés-Díaz, InmaculadaPazo-Cid, Roberto AntonioCarmona-Bayonas, Alberto2023-01-252023-01-252018-11-29http://hdl.handle.net/10668/13261Treatment 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.enAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/First-line chemotherapyGemcitabineMetastatic pancreatic adenocarcinomaNab-paclitaxelReal-lifeSurvivalAdultAgedAlbuminsAntineoplastic Combined Chemotherapy ProtocolsComorbidityDeoxycytidineFemaleHumansMaleMiddle AgedNeoplasm MetastasisNeoplasm StagingPaclitaxelPancreatic NeoplasmsPrognosisRetrospective StudiesSurvival AnalysisTreatment OutcomeGemcitabineresearch article30497432open access10.1186/s12885-018-5101-31471-2407PMC6267080https://doi.org/10.1186/s12885-018-5101-3https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6267080/pdf