1523P - Efficacy of gemcitabine plus nab-paclitaxel in second-line treatment of metastatic pancreatic cancer

Background

While FOLFIRINOX or gemcitabine plus nab-paclitaxel represents the standard approach for first-line treatment of metastatic pancreatic cancer, there is no consensus on second-line treatment. Despite the numerous studies that have been conducted on second-line treatment, there is currently no randomised trial evaluating the efficacy of gemcitabine plus nab-paclitaxel as second-line treatment. The objective of this study was to examine the efficacy of gemcitabine plus nab-paclitaxel in second-line treatment.

Methods

This study is a retrospective analysis of data from 22 centres across various provinces in Turkey. The primary outcome was progression-free survival (PFS) in patients receiving gemcitabine nab-paclitaxel in second-line treatment. Secondary outcomes included overall survival (OS), treatment efficacy according to Eastern Cooperative Oncology Group (ECOG) performance status (PS) and tumour marker (CEA, CA 19-9) levels.

Results

A total of 260 patients from 22 centers were included in the study, with a median age at diagnosis of 60.0 years (31.0 to 81.1). The median PFS was 6.8 months (95% confidence interval [CI], 6.2 to 7.3) and the median OS was 18.0 months (95% CI, 16.5 to 19.4) in patients receiving first-line treatment in the metastatic stage. The median PFS was 6.4 months (95% CI, 5.6 to 7.1) and the OS was 10.6 months (95% CI, 9.2 to 12.0) in patients receiving gemcitabine plus nab-paclitaxel in second-line treatment. The median PFS was 8.4 months (95% CI, 6.8 to 9.9) in patients with normal CEA levels and 5.2 months (95% CI, 4.3 to 6.1) in patients with high CEA levels. This difference was statistically significant (P < 0.01). The median PFS was 7.7 months (95% CI, 4.9 to 10.5) in patients with normal CA 19-9 levels and 6.1 months (95% CI, 5 to 7.1) in patients with high CA 19-9 levels (P = 0.016). PFS was 7.3 months (95% confidence interval (95% CI, 6.2 to 8.3) in patients with ECOG PS 0-1 and 4.9 months (95% CI, 4.1 to 5.7) in patients with PS 2 (P < 0.01).

Conclusions

In this study, we demonstrated that gemcitabine plus nab-paclitaxel contributes to both OS and PFS in second-line treatment of metastatic pancreatic cancer. We believe that this treatment option is particularly beneficial for patients with good ECOG PS and a young age.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.