Second-line nab-paclitaxel and gemcitabine for advanced pancreatic cancer following FOLFIRINOX: outcomes and insights

Abstract

We aimed to evaluate the efficacy and safety of a combination of nab-paclitaxel and gemcitabine as a second-line treatment, after first-line treatment with FOLFIRINOX regimen, for metastatic or locally advanced unresectable pancreatic cancer. This national multicenter retrospective study included patients with metastatic or unresectable locally advanced pancreatic cancer treated with FOLFIRINOX in the first-line setting. After progression with first-line treatment, all patients were treated with nab-paclitaxel and gemcitabine as second-line treatment. This study included 180 patients across 15 centers with a median age of 60 years. The median overall survival (OS) of all patients was 17.9 months. The median progression-free survival (PFS) following first-line chemotherapy was 8.4 months, whereas the median PFS achieved with nab-paclitaxel plus gemcitabine treatment was 5.5 months. Regarding treatment-related adverse events (TRAEs), all grades of non-hematologic adverse events (AEs) occurred at expected rates. However, the incidence of hematologic TRAEs was lower than anticipated. Grade 5 TRAEs were not observed. Patients who responded well to first-line FOLFIRINOX demonstrated a trend toward better outcomes with NG, although this did not reach statistical significance. The combination of nab-paclitaxel and gemcitabine is safe and effective as second-line treatmentfor locally advanced unresectable or metastatic pancreatic cancer after FOLFIRINOX.