Gemcitabine plus nab-paclitaxel with initial dose reduction for older patients with advanced pancreatic cancer

Objectives: For older patients with pancreatic cancer (PC), the benefits of gemcitabine plus nab-paclitaxel (GnP) are still uncertain, and the toxicity may be excessive. We aimed to examine the efficacy and safety of modified GnP (m-GnP), which is a nab-paclitaxel reduced regimen, for older patients (>= 75 years) with advanced PC. Materials and Methods: In total, 34 patients met the eligibility criteria for study inclusion between 2015 and 2020. We evaluated the overall survival (OS), progression-free survival (PFS), best response, and adverse events associated with m-GnP treatment. Results: The median OS and PFS were 15.4 months and 5.9 months, respectively. The best response was partial response in 29% (10/34), stable disease in 53% (18/34), and progressive disease in 15% of patients (5/34); one patient was not evaluated. Among the grade 3 or higher hematological adverse events, neutropenia was the most frequent, occurring in 38% of patients (13/34), whereas febrile neutropenia occurred in 3% (1/34). Grade 3 or higher non-hematological adverse events occurred in 12% of patients (4/34). Early discontinuation owing to intolerable adverse events occurred in one patient, and there were no chemotherapy-related deaths. Conclusions: The present study demonstrated that m-GnP exhibited good efficacy with acceptable toxicity. To avoid early discontinuation and maintain dose intensities, initial dose reduction may be a good option for older patients with PC when receiving GnP. (C) 2020 Elsevier Ltd. All rights reserved.

Automated summary

This study evaluated the efficacy and safety of modified gemcitabine plus nab-paclitaxel for older patients with pancreatic cancer. Results showed good efficacy with acceptable toxicity, with a median overall survival of 15.4 months and progression-free survival of 5.9 months in 34 patients.