Prognostic factors for survival with nab-paclitaxel plus gemcitabine in metastatic pancreatic cancer in real-life practice : the ANICE-PaC study
BACKGROUND: Treatment with nab-paclitaxel plus gemcitabine increases survival in patients with metastatic pancreatic cancer. However, the assessment of treatment efficacy and safety in non-selected patients in a real-life setting may provide useful information to support decision-making processes in routine practice.
METHODS: Retrospective, multicenter study including patients with metastatic pancreatic cancer, who started first-line treatment with nab-paclitaxel plus gemcitabine between December 2013 and June 2015 according to routine clinical practice. In addition to describing the treatment pattern, overall survival (OS) and progression-free survival (PFS) were assessed for the total sample and the exploratory subgroups based on the treatment and patients' clinical characteristics.
RESULTS: All 210 eligible patients had a median age of 65.0 years (range 37-81). Metastatic pancreatic adenocarcinoma was recurrent in 46 (21.9%) patients and de novo in 164 (78.1%); 38 (18%) patients had a biliary stent. At baseline, 33 (18.1%) patients had an ECOG performance status ≥2. Patients received a median of four cycles of treatment (range 1-21), with a median duration of 3.5 months; 137 (65.2%) patients had a dose reduction of nab-paclitaxel and/or gemcitabine during treatment, and 33 (17.2%) discontinued treatment due to toxicity. Relative dose intensity (RDI) for nab-paclitaxel, gemcitabine, and the combined treatment was 66.7%. Median OS was 7.2 months (95% CI 6.0-8.5), and median PFS was 5.0 months (95% CI 4.3-5.9); 50 patients achieved either a partial or complete response (ORR 24.6%). OS was influenced by baseline ECOG PS, NLR and CA 19.9, but not by age ≥ 70 years and/or the presence of hepatobiliary stent or RDI < 85%. All included variables, computed as dichotomous, showed a significant contribution to the Cox regression model to build a nomogram for predicting survival in these patients: baseline ECOG 0-1 vs. 2-3 (p = 0.030), baseline NLR > 3 vs. ≤ 3 (p = 0.043), and baseline CA 19.9 > 37 U/mL vs. ≤37 U/mL (p = 0.004).
CONCLUSIONS: Nab-Paclitaxel plus gemcitabine remain effective in a real-life setting, despite the high burden of dose reductions and poorer performance of these patients. A nomogram to predict survival using baseline ECOG performance status, NLR and CA 19.9 is proposed.
Medienart: |
E-Artikel |
---|
Erscheinungsjahr: |
2018 |
---|---|
Erschienen: |
2018 |
Enthalten in: |
Zur Gesamtaufnahme - volume:18 |
---|---|
Enthalten in: |
BMC cancer - 18(2018), 1 vom: 29. Nov., Seite 1185 |
Sprache: |
Englisch |
---|
Beteiligte Personen: |
Fernández, Ana [VerfasserIn] |
---|
Links: |
---|
Anmerkungen: |
Date Completed 15.03.2019 Date Revised 07.12.2022 published: Electronic Citation Status MEDLINE |
---|
doi: |
10.1186/s12885-018-5101-3 |
---|
funding: |
|
---|---|
Förderinstitution / Projekttitel: |
|
PPN (Katalog-ID): |
NLM291283756 |
---|
LEADER | 01000naa a22002652 4500 | ||
---|---|---|---|
001 | NLM291283756 | ||
003 | DE-627 | ||
005 | 20231225070531.0 | ||
007 | cr uuu---uuuuu | ||
008 | 231225s2018 xx |||||o 00| ||eng c | ||
024 | 7 | |a 10.1186/s12885-018-5101-3 |2 doi | |
028 | 5 | 2 | |a pubmed24n0970.xml |
035 | |a (DE-627)NLM291283756 | ||
035 | |a (NLM)30497432 | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
100 | 1 | |a Fernández, Ana |e verfasserin |4 aut | |
245 | 1 | 0 | |a Prognostic factors for survival with nab-paclitaxel plus gemcitabine in metastatic pancreatic cancer in real-life practice |b the ANICE-PaC study |
264 | 1 | |c 2018 | |
336 | |a Text |b txt |2 rdacontent | ||
337 | |a ƒaComputermedien |b c |2 rdamedia | ||
338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
500 | |a Date Completed 15.03.2019 | ||
500 | |a Date Revised 07.12.2022 | ||
500 | |a published: Electronic | ||
500 | |a Citation Status MEDLINE | ||
520 | |a BACKGROUND: Treatment with nab-paclitaxel plus gemcitabine increases survival in patients with metastatic pancreatic cancer. However, the assessment of treatment efficacy and safety in non-selected patients in a real-life setting may provide useful information to support decision-making processes in routine practice | ||
520 | |a METHODS: Retrospective, multicenter study including patients with metastatic pancreatic cancer, who started first-line treatment with nab-paclitaxel plus gemcitabine between December 2013 and June 2015 according to routine clinical practice. In addition to describing the treatment pattern, overall survival (OS) and progression-free survival (PFS) were assessed for the total sample and the exploratory subgroups based on the treatment and patients' clinical characteristics | ||
520 | |a RESULTS: All 210 eligible patients had a median age of 65.0 years (range 37-81). Metastatic pancreatic adenocarcinoma was recurrent in 46 (21.9%) patients and de novo in 164 (78.1%); 38 (18%) patients had a biliary stent. At baseline, 33 (18.1%) patients had an ECOG performance status ≥2. Patients received a median of four cycles of treatment (range 1-21), with a median duration of 3.5 months; 137 (65.2%) patients had a dose reduction of nab-paclitaxel and/or gemcitabine during treatment, and 33 (17.2%) discontinued treatment due to toxicity. Relative dose intensity (RDI) for nab-paclitaxel, gemcitabine, and the combined treatment was 66.7%. Median OS was 7.2 months (95% CI 6.0-8.5), and median PFS was 5.0 months (95% CI 4.3-5.9); 50 patients achieved either a partial or complete response (ORR 24.6%). OS was influenced by baseline ECOG PS, NLR and CA 19.9, but not by age ≥ 70 years and/or the presence of hepatobiliary stent or RDI < 85%. All included variables, computed as dichotomous, showed a significant contribution to the Cox regression model to build a nomogram for predicting survival in these patients: baseline ECOG 0-1 vs. 2-3 (p = 0.030), baseline NLR > 3 vs. ≤ 3 (p = 0.043), and baseline CA 19.9 > 37 U/mL vs. ≤37 U/mL (p = 0.004) | ||
520 | |a CONCLUSIONS: Nab-Paclitaxel plus gemcitabine remain effective in a real-life setting, despite the high burden of dose reductions and poorer performance of these patients. A nomogram to predict survival using baseline ECOG performance status, NLR and CA 19.9 is proposed | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a Multicenter Study | |
650 | 4 | |a First-line chemotherapy | |
650 | 4 | |a Gemcitabine | |
650 | 4 | |a Metastatic pancreatic adenocarcinoma | |
650 | 4 | |a Nab-paclitaxel | |
650 | 4 | |a Real-life | |
650 | 4 | |a Survival | |
650 | 7 | |a 130-nm albumin-bound paclitaxel |2 NLM | |
650 | 7 | |a Albumins |2 NLM | |
650 | 7 | |a Deoxycytidine |2 NLM | |
650 | 7 | |a 0W860991D6 |2 NLM | |
650 | 7 | |a Paclitaxel |2 NLM | |
650 | 7 | |a P88XT4IS4D |2 NLM | |
650 | 7 | |a Gemcitabine |2 NLM | |
700 | 1 | |a Salgado, Mercedes |e verfasserin |4 aut | |
700 | 1 | |a García, Adelaida |e verfasserin |4 aut | |
700 | 1 | |a Buxò, Elvira |e verfasserin |4 aut | |
700 | 1 | |a Vera, Ruth |e verfasserin |4 aut | |
700 | 1 | |a Adeva, Jorge |e verfasserin |4 aut | |
700 | 1 | |a Jiménez-Fonseca, Paula |e verfasserin |4 aut | |
700 | 1 | |a Quintero, Guillermo |e verfasserin |4 aut | |
700 | 1 | |a Llorca, Cristina |e verfasserin |4 aut | |
700 | 1 | |a Cañabate, Mamen |e verfasserin |4 aut | |
700 | 1 | |a López, Luis Jesús |e verfasserin |4 aut | |
700 | 1 | |a Muñoz, Andrés |e verfasserin |4 aut | |
700 | 1 | |a Ramírez, Patricia |e verfasserin |4 aut | |
700 | 1 | |a González, Paula |e verfasserin |4 aut | |
700 | 1 | |a López, Carlos |e verfasserin |4 aut | |
700 | 1 | |a Reboredo, Margarita |e verfasserin |4 aut | |
700 | 1 | |a Gallardo, Elena |e verfasserin |4 aut | |
700 | 1 | |a Sanchez-Cánovas, Manuel |e verfasserin |4 aut | |
700 | 1 | |a Gallego, Javier |e verfasserin |4 aut | |
700 | 1 | |a Guillén, Carmen |e verfasserin |4 aut | |
700 | 1 | |a Ruiz-Miravet, Nuria |e verfasserin |4 aut | |
700 | 1 | |a Navarro-Pérez, Víctor |e verfasserin |4 aut | |
700 | 1 | |a De la Cámara, Juan |e verfasserin |4 aut | |
700 | 1 | |a Alés-Díaz, Inmaculada |e verfasserin |4 aut | |
700 | 1 | |a Pazo-Cid, Roberto Antonio |e verfasserin |4 aut | |
700 | 1 | |a Carmona-Bayonas, Alberto |e verfasserin |4 aut | |
773 | 0 | 8 | |i Enthalten in |t BMC cancer |d 2001 |g 18(2018), 1 vom: 29. Nov., Seite 1185 |w (DE-627)NLM111431948 |x 1471-2407 |7 nnns |
773 | 1 | 8 | |g volume:18 |g year:2018 |g number:1 |g day:29 |g month:11 |g pages:1185 |
856 | 4 | 0 | |u http://dx.doi.org/10.1186/s12885-018-5101-3 |3 Volltext |
912 | |a GBV_USEFLAG_A | ||
912 | |a GBV_NLM | ||
951 | |a AR | ||
952 | |d 18 |j 2018 |e 1 |b 29 |c 11 |h 1185 |