Impact of nab-paclitaxel-based second-line chemotherapy in metastatic pancreatic cancer

Neelakanta Dadi, Melissa Stanley, Safi Shahda, Bert H. O'neil, Amikar Sehdev

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Background: Pancreatic ductal adenocarcinoma (PDAC) is a lethal malignancy with median survival of 20% at 1 year. We conducted a retrospective study to assess the efficacy and tolerability of nab-paclitaxel (NP)-based secondline chemotherapy in metastatic PDAC. Patients and Methods: The Indiana University Simon Cancer Center pancreatic cancer program was used to identify patients with metastatic PDAC who received any second-line chemotherapy. Demographic, clinical and outcomes data were collected by manual chart abstraction. Patients were divided into two groups: a NP-based treatment group and a non- NP-based treatment group. Overall (OS) and progression-free (PFS) survival were estimated using Kaplan-Meier method. Cox proportional hazards regression was used for multivariate analyses. Results: A total of 120 patients received second-line chemotherapy. There were 47 (39%) patients in the NP group and 73 (61%) in the non-NP group. As compared to the non- NP group, the NP group showed improved median PFS [2.8 vs. 2.1 months; hazard ratio (HR)=0.62, 95% confidence interval (CI)=0.38-1.02; p=0.06] and median OS (7.5 vs. 4.7 months; HR=0.67, 95% CI=0.45-1.00; p=0.05). Multivariate analyses adjusted for age showed a significantly improved PFS (adjusted HR=0.60, 95% CI=0.36-0.98; p=0.04) and a suggestion of improved OS (adjusted HR=0.67, 95% CI=0.44- 1.01, p=0.05) in the NP group as compared to non-NP group. Serious adverse events were seen in 13.3% of patients in the non-NP group and 17.1% patients in the NP group. Conclusion: In a single-institution retrospective cohort study, we report a significant improvement in the PFS and suggestion of improvement in the OS with NP-based secondline chemotherapy with an acceptable toxicity rate.

Original languageEnglish (US)
Pages (from-to)5533-5539
Number of pages7
JournalAnticancer Research
Volume37
Issue number10
DOIs
StatePublished - Oct 1 2017

Keywords

  • Chemotherapy
  • Metastatic pancreatic cancer
  • Nabpaclitaxel
  • Overall survival
  • Progression-free survival

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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