Gemcitabine plus nab-paclitaxel followed by maintenance treatment with gemcitabine alone as first-line treatment for older adults with locally advanced or metastatic pancreatic cancer.

Autor: Petrioli R; Medical Oncology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Italy. Electronic address: r.petrioli@ao-siena.toscana.it., Torre P; Medical Oncology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Italy., Pesola G; Medical Oncology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Italy., Paganini G; General Medicine& Oncology, Pieve di Coriano Hospital, ASST Mantova, Italy., Paolelli L; Medical Oncology, Vito Fazzi Hospital, Lecce, Italy., Miano ST; Medical Oncology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Italy., Martellucci I; Medical Oncology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Italy., Francini G; Medical Oncology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Italy., Francini E; La Sapienza University, Rome, Italy; Medical Oncology Unit, Misericordia Hospital, Grosseto, Italy.
Jazyk: angličtina
Zdroj: Journal of geriatric oncology [J Geriatr Oncol] 2020 May; Vol. 11 (4), pp. 647-651. Date of Electronic Publication: 2019 Aug 27.
DOI: 10.1016/j.jgo.2019.08.008
Abstrakt: Objectives: The aim of this study was to evaluate the efficacy and safety of the combination Gemcitabine (Gem) plus nab-Paclitaxel (NabP) (Gem/NabP), followed by maintenance Gem in older adults with locally advanced or metastatic pancreatic cancer (PC).
Materials and Methods: In this prospective observational study, the induction chemotherapy consisted of NabP 125 mg/m 2 followed by Gem 1000 mg/m 2 on days 1, 8, and 15 of a 4-week cycle. After a maximum of 3 cycles, patients without evidence of progressive disease (PD) were administered Gem 1000 mg/m2 weekly for 3 of 4 weeks as maintenance therapy until documentation of PD or unacceptable toxicity. The primary endpoint was six-month disease-control rate (DCR).
Results: Overall, 36 patients >70 years with metastatic or locally advanced PC were enrolled at participating Institutions. After completion of Gem/NabP, 18 (50%) patients achieved partial response, 13 (36%) had stable disease, and 5 (14%) had PD. Thirty-one patients (86%) received Gem monotherapy as maintenance treatment for a median of 3 cycles (range, 2-9 cycles). Six-month DCR was 61% (95% CI, 45-77), median PFS was 6.4 months (95% CI, 5.4-8.3), and median OS was 13.4 months (95% CI, 11.1-16.7). During Gem/NabP regimen, the most common grade 3 toxicity included neutropenia (22%), anemia (19%) and thrombocytopenia (8%). Grade 3 neuropathy was not observed. During Gem maintenance therapy, grade 3 hematological toxicity was described in 6 patients (19%).
Conclusion: Gem/NabP followed by maintenance Gem appears to be safe and effective for older patients with locally advanced or metastatic PC.
Competing Interests: Declaration of Competing Interest All the authors declare that no potential or actual conflicts of interest exist.
(Copyright © 2019. Published by Elsevier Ltd.)
Databáze: MEDLINE
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