nab-Paclitaxel, Gemcitabine Up Survival in Pancreatic Cancer
Improved overall and progression-free survival, response rate with combo versus gemcitabine
WEDNESDAY, Oct. 16 (HealthDay News) -- For patients with metastatic pancreatic cancer, treatment with albumin-bound paclitaxel (nab-paclitaxel) plus gemcitabine is more effective than gemcitabine alone, according to a study published online Oct. 16 in the New England Journal of Medicine.
Daniel D. von Hoff, M.D., from the Translational Genomics Research Institute in Phoenix, and colleagues conducted a phase 3 study of the efficacy and safety of nab-paclitaxel plus gemcitabine versus gemcitabine monotherapy for 861 patients with metastatic pancreatic cancer. Participants were randomized to receive nab-paclitaxel plus gemcitabine (431 patients) or gemcitabine monotherapy (430 patients).
The researchers found that the median overall survival was significantly increased in the combination group versus the monotherapy group (8.5 versus 6.7 months; hazard ratio for death, 0.72). The survival rate was 35 versus 22 percent at one year and 9 versus 4 percent at two years. The median progression-free survival was significantly longer in the combination group (5.5 versus 3.7 months; hazard ratio for disease progression or death, 0.69); the response rate was 23 versus 7 percent (P < 0.001). Neutropenia, fatigue, and neuropathy were the most common adverse events of grade 3 or higher, and were more common in the nap-paclitaxel-gemcitabine group.
"In conclusion, nab-paclitaxel combined with gemcitabine is superior to gemcitabine alone but causes more myelosuppression and peripheral neuropathy," the authors write.
The study was funded by Celgene, the manufacturer of nab-paclitaxel.
Abstract (http://www.nejm.org/doi/full/10.1056/NEJMoa1304369?query=featured_home )Full Text (http://www.nejm.org/doi/full/10.1056/NEJMoa1304369?query=featured_home#t=article )