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Poster display session

3460 - Treatment patterns, clinical characteristics, and outcomes of patients (pts) with metastatic pancreatic cancer (MPC) treated with nab-paclitaxel (nab-P) plus gemcitabine (GEM) in real-life practice. ANICE-Pac trial.

Date

09 Sep 2017

Session

Poster display session

Presenters

Ana Fernández

Citation

Annals of Oncology (2017) 28 (suppl_5): v209-v268. 10.1093/annonc/mdx369

Authors

A. Fernández1, M. Salgado2, A. García3, E. Buxò4, R. Vera5, J. Adeva6, P. Jiménez7, G. Quintero8, C. Llorca9, M. Cañabate10, L.J. López11, A. Muñoz12, P. Ramírez13, P. González14, C. López15, M. Reboredo16, E. Gallardo17, M. Sánchez18, J. Gallego19, C. Guillén20

Author affiliations

  • 1 Medical Oncology, Complejo Universitario Ourense, 32003 - Ourense/ES
  • 2 Oncology, Complejo Universitario Ourense, 32003 - Ourense/ES
  • 3 Medical Oncology, Institut Català d'Oncologia (ICO) Hospital Dr. Trueta, 17007 - Girona/ES
  • 4 Medical Oncology, Hospital Clínic de Barcelona, 08036 - Barcelona/ES
  • 5 Medical Oncology, Complejo Hospitalario de Navarra, 31008 - Pamplona/ES
  • 6 Medical Oncology, Hospital 12 de Octubre, 28041 - Madrid/ES
  • 7 Medical Oncology, Hospital Universitario Central de Asturias, Oviedo/ES
  • 8 Medical Oncology, Hospital Lucus Augusti, Lugo/ES
  • 9 Medical Oncology, Hospital de Elda, 03600 - Elda/ES
  • 10 Medical Oncology, Hospital Público Lluis Alcanyis de Xátiva, 46800 - Xàtiva/ES
  • 11 Medical Oncology, Hospital Virgen de la Salud, 45005 - Toledo/ES
  • 12 Medical Oncology Department, Hospital Gregorio Marañon, Madrid/ES
  • 13 Medical Oncology, Hospital Puerta del Mar, 11009 - Cádiz/ES
  • 14 Medical Oncology, Hospital Universitario de Vigo, 36204 - Vigo/ES
  • 15 Medical Oncology, Hospital Marqués de Valdecilla, 39008 - Santander/ES
  • 16 Medical Oncology, Hospital A Coruña Teresa Herrera, 15006 - A Coruna/ES
  • 17 Medical Oncology, Hospital de Pontevedra, 36002 - Pontevedra/ES
  • 18 Medical Oncology, Hospital Morales Meseguer, Murcia/ES
  • 19 Medical Oncology, Hospital de Elche, Elche/ES
  • 20 Medical Oncology, Hospital Ramón y Cajal, Madrid/ES
More

Resources

Abstract 3460

Background

Combined treatment of nab-P plus GEM increases survival in patients with MPC. However, treatment efficacy and safety need to be assessed in real-life practice, including pts irrespective of their clinical characteristics and number of dose administrated and treatment duration.

Methods

Retrospective, multicenter study including pts with MPC who started first-line treatment with nab-P plus GEM between December 2013 and June 2015 according to routine clinical practice. Overall survival (OS) and progression-free survival (PFS) were assessed for the total sample and the exploratory subgroups based on treatment and clinical characteristics of pts.

Results

210 pts (60% males) were enrolled with a median age of 65 years (range 37 – 81); 25% were ≥ 70 years. MPC was de novo and recurrent in 78% and 22% of pts, respectively; 18% had a biliary stent. At baseline, 53% of pts had Neutrophil lymphocyte rate (NLR)> 3, 82% CA 19.9 > 35 U/mL, and 18% ECOG ≥ 2. Pts received a median of 4 cycles (1 – 21); 32% started treatment with a dose reduction and 17% received ≤ 30 days of treatment, mainly due to toxicity (33%) or progression (30%); 25% of pts achieved objective response, and median OS and PFS were 7.2 (95%CI 6.0 – 8.5) and 5.0 (4.3 – 5.9) months (mo), respectively. Compared with pts treated during > 30 days, those with ≤ 30 treatment had lower OS (8.6 [7.2 – 10.2] vs. 1.9 [0.8 – 2.3] mo; p  35 U/mL (p = 0.002), and ECOG ≥ 2 (p = 0.018); 29% pts experienced at least one grade 3-4 adverse event, mostly neutropenia (14%).

Conclusions

Our results revealed that real-life MPC pts tend to be older and have worse performance status (ECOG) than those included in clinical trials with restrictive selection criteria. In fact, many pts either did not complete 1 month of treatment or started treatment with a dose reduction. Despite these limitations, nab-P plus GEM remains effective in this clinical setting. ECOG ≥ 2, NLR > 3, and CA 19.9 > 35 U/mL are associated with lower OS.

Clinical trial identification

GIT-ADE-2015-02

Legal entity responsible for the study

Galician Group for the Treatment of Digestive Tumors (GITuD)

Funding

Galician Group for the Treatment of Digestive Tumors (GITuD)

Disclosure

A. García: Received honoraria from Celgene. C. Guillén: Consultant/advisor board member for Celgene, and received remuneration for traveling and accomodations by Celgene. All other authors have declared no conflicts of interest.

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