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http://dx.doi.org/10.5009/gnl18220

Efficacy of Nab-Paclitaxel Plus Gemcitabine and Prognostic Value of Peripheral Neuropathy in Patients with Metastatic Pancreatic Cancer  

You, Min Su (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine)
Ryu, Ji Kon (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine)
Choi, Young Hoon (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine)
Choi, Jin Ho (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine)
Huh, Gunn (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine)
Paik, Woo Hyun (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine)
Lee, Sang Hyub (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine)
Kim, Yong-Tae (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine)
Publication Information
Gut and Liver / v.12, no.6, 2018 , pp. 728-735 More about this Journal
Abstract
Background/Aims: The combination of nab-paclitaxel and gemcitabine (nab-P/Gem) is widely used for treating metastatic pancreatic cancer (MPC). We aimed to evaluate the therapeutic outcomes and prognostic role of treatment-related peripheral neuropathy in patients with MPC treated with nab-P/Gem in clinical practice. Methods: MPC patients treated with nab-P/Gem as the first-line chemotherapy were included. All 88 Korean patients underwent at least two cycles of nab-P/Gem combination chemotherapy (125 and $1,000mg/m^2$, respectively). Treatment-related adverse events were monitored through periodic follow-ups. Overall survival and progression-free survival were estimated by the Kaplan-Meier method, and the Cox proportional hazards regression linear model was applied to assess prognostic factors. To evaluate the prognostic value of treatment-related peripheral neuropathy, the landmark point analysis was used. Results: Patients underwent a mean of $6.7{\pm}4.2$ cycles during $6.3{\pm}4.4$ months. The median overall survival and progression-free survival rates were 14.2 months (95% confidence interval [CI], 11.8 to 20.3 months) and 8.4 months (95% CI, 7.1 to 13.2 months), respectively. The disease control rate was 84.1%; a partial response and stable disease were achieved in 30 (34.1%) and 44 (50.0%) patients, respectively. Treatment-related peripheral neuropathy developed in 52 patients (59.1%), and 13 (14.8%) and 16 (18.2%) patients experienced grades 2 and 3 neuropathy, respectively. In the landmark model, at 6 months, treatment-related peripheral neuropathy did not have a significant correlation with survival (p=0.089). Conclusions: Nab-P/Gem is a reasonable choice for treating MPC, as it shows a considerable disease control rate while the treatment-related peripheral neuropathy was tolerable. The prognostic role of treatment-related neuropathy was limited.
Keywords
Pancreatic neoplasm; Metastasis; Chemotherapy; Gemcitabine; Nab-paclitaxel;
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