Prognostic factors of survival in patients treated with nab-paclitaxel plus gemcitabine regimen for advanced or metastatic pancreatic cancer: A single institutional experience
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Giovanni Lo Re1, Davide A. Santeufemia1, Luisa Foltran1, Ettore Bidoli2, Stefano M.M. Basso3, Franco Lumachi4
1Oncology Unit, S. Maria degli Angeli Hospital, 33170 Pordenone, Italy
2Epidemiology Unit, Centro di Riferimento Oncologico (CRO), 33081 Aviano, Pordenone, Italy
3Surgery 2, S. Maria degli Angeli Hospital, 33170 Pordenone, Italy
4Department of Surgery, Oncology and Gastroenterology, University of Padua, School of Medicine, 35128 Padova, Italy
Giovanni Lo Re, e-mail: firstname.lastname@example.org
Keywords: advanced pancreatic cancer, metastasis, nab-paclitaxel, gemcitabine, prognostic factors
Received: December 11, 2014 Accepted: January 12, 2015 Published: March 10, 2015
The objectives of this study were to evaluate the effectiveness of nab-paclitaxel plus gemcitabine (NAB-P/GEM) regimen in an unselected population of patients with advanced inoperable or metastatic pancreatic cancer (PC), and to identify the prognostic factors influencing overall survival (OS).
Patients with age < 85 years, ECOG-performance status (PS) < 3, and adequate renal, hepatic and hematologic function were eligible. NAB-P (125 mg/m2) and GEM (1000 mg/m2) day 1,8,15 every 4 weeks were employed for 3–6 cycles or until highest response.
Overall, 147 cycles (median 4, range 1–11 cycles) were administered on thirty-seven consecutive patients (median 66 years old, range 40–82) treated. The median overall progression-free survival and OS were 6.2 and 9.2 months, respectively. The G 3–4 dose-limiting toxicity were neutropenia (20.7%), severe anemia (17.2%), and cardiovascular toxicity (10.3%). PS, number of cycles, baseline CA 19–9 and LDH serum levels, were found to be significantly related to OS. The multivariate analysis showed that both number of cycles (HR = 9.14, 95% CI 1.84–45.50, p = 0.001) and PS (HR = 13.18, 95% CI 2.73–63.71, p = 0.001) were independently associated with OS.
NAB-P/GEM regimen should be used in all patients with advanced or metastatic PC, with the exception of those with serious contraindications to chemotherapy, such as severe renal or hepatic impairment or major cardiovascular diseases.
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