A clinical trial to assess the feasibility and efficacy of nab-paclitaxel plus gemcitabine for elderly patients with unresectable advanced pancreatic cancer

• DOI: 10.1007/s10147-019-01511-0
• Publication Date: 2019-07-15T11:04:38Z
• Authors: Rikiya Hasegawa; Kosuke Okuwaki; Mitsuhiro Kida; Hiroshi Yamauchi; Yusuke Kawaguchi; Takaaki Matsumoto; Toru Kaneko; Eiji Miyata; Kazuho Uehara; Tomohisa Iwai; Masafumi Watanabe; Takahiro Kurosu; Hiroshi Imaizumi; Takashi Ohno; Wasaburo Koizumi
• Keywords: Tolerability; Regimen; Performance status

The efficacy and safety of nanoparticle albumin-bound paclitaxel (nab-PTX) plus gemcitabine (GEM) in elderly Japanese patients with pancreatic cancer remain unclear. Therefore, we prospectively investigated the tolerability and efficacy of nab-PTX + GEM in Japanese patients aged ≥ 75 years with non-curatively resectable pancreatic cancer.We treated eligible patients (n = 27) with nab-PTX + GEM until disease progression, appearance of adverse events, or withdrawal of consent. The primary endpoints included adverse events as well as dosing- and survival-related parameters.The rates of 2-cycle completion were 48.1% for nab-PTX and 55.6% for GEM; the relative dose intensities for the 7th (median) treatment cycle were 65.1% and 74.1%, respectively, whereas the dose-reduction rates were 81.5% and 48.1%, respectively. Grade 3 or higher hemotoxicity was observed in 14 of 27 subjects (51.9%); moreover, 22% experienced grade ≥ 3 peripheral nerve disorder and 1 patient (3.7%) died owing to chemotherapy-related interstitial pneumonia. The disease control rate was 92.6% (25/27), while the median progression-free and overall survival times were 7 and 10.3 months, respectively.The nab-PTX + GEM regimen is as efficacious in elderly patients who meet certain criteria as it is in previously reported non-elderly patients. The regimen is feasible with appropriate dose adjustments and attention to adverse events.Clinical trial registration number: UMIN000018907.