Efficacy and safety of gemcitabine plus nab-paclitaxel combination chemotherapy in patients with advanced pancreatic cancer refractory to gemcitabine monotherapy

Abstract Background: This study aimed to investigate the efficacy and safety of gemcitabine (GEM) plus nab-paclitaxel (nab-PTX): (GnP), which remain unknown, in patients with advanced pancreatic cancer (PC) who showed good tolerance to GEM monotherapy prior to being refractory to it. Methods: We retrospectively analyzed the data ofpatients with locally advanced or metastatic PC who received GEM followed by GnP between December 2014 and March 2019, regardless of the treatment line. Results: A total of 14 patients who received GnP after becoming refractory to GEM were included in this study. Eight patients were included in the nab-PTX naïve group: seven of whom were treated with GEM monotherapy as first-line chemotherapy and one was refractory to GEM monotherapy after modified FOLFIRINOX treatment. The other six patients were included in the nab-PTX reintroduction group. In this group, all patients received GnP followed by GEM maintenance therapy to prevent adverse events, such as peripheral neuropathy and fatigue. The nab-PTX naïve and reintroduction groups showed partial response in 2 and 0 patients, with a median progression-free survival of 7.6 and 1.4 months and median overall survival of 9.4 and 6.2 months, respectively. In the safety analysis, grade 3 peripheral neuropathy was observed in one patient in the nab-PTX reintroduction group, while other observed adverse events were grade 1 or 2. Conclusion: This study suggests that GnP is safe and effective even after GEM-refractory PC, and GEM treatment followed by GnP may be a potentially effective treatment option for patients with nab-PTX-naïve PC.