Abstract
Background: Given the tolerability of nPG in first-line therapy, we desired to evaluate the response and toxicity profiles of second-line gemcitabine with nab-paclitaxel (nPG) following FOLFIRINOX. Methods: We retrospectively identified 30 patients who received first-line FOLFIRINOX for unresectable or metastatic pancreatic adenocarcinoma followed by second-line nPG. Response was evaluated by RECIST criteria and carbohydrate antigen 19-9 (CA19-9) change. Results: Median age was 63 years with 77% percent having metastatic disease. Nineteen patients (63%) achieved PR based on CA19-9. Median overall survival (OS) with nPG was 12.4 months (mo) and median progression-free survival (PFS) was 3.8 mo. Median PFS and OS for patients with at least stable CA19-9 were 4.7 and 14 mo since initiation of nPG. Patients with an increased CA19-9 level during nPG had a shorter median PFS (1.4 mo) and OS (5.4 mo). A significant PFS difference was demonstrated in patients with at least stable disease as the best RECIST response versus in those with progressive disease (5.5 vs. 1.9 mo, P < 0.001). Grade 3/4 adverse events include thrombocytopenia (33%), anemia (23%), nausea (17%), lymphopenia (7%), infectious complications (6%), diarrhea (3%), and neuropathy (3%). Conclusions: This study demonstrates a clinical benefit of second-line nPG.
Original language | English (US) |
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Pages (from-to) | 556-565 |
Number of pages | 10 |
Journal | Journal of Gastrointestinal Oncology |
Volume | 8 |
Issue number | 3 |
DOIs | |
State | Published - Jun 1 2017 |
Externally published | Yes |
Keywords
- Carbohydrate antigen 19-9 (CA19-9)
- FOLFIRINOX
- Gemcitabine
- Nab-paclitaxel
- Pancreatic cancer
ASJC Scopus subject areas
- Oncology
- Gastroenterology