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

Roberto Petrioli; Pamela Torre; Guido Pesola; Giovanni Paganini; Loretta Paolelli; Salvatora Tindara Miano; Ignazio Martellucci; Guido Francini; Edoardo Francini

doi:10.1016/j.jgo.2019.08.008

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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

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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

Roberto Petrioli, Pamela Torre, Guido Pesola, Giovanni Paganini, Loretta Paolelli, Salvatora Tindara Miano, Ignazio Martellucci, Guido Francini and Edoardo Francini

Journal of geriatric oncology, Vol.11(4), pp.647-651

05/01/2020

DOI: 10.1016/j.jgo.2019.08.008

PMID: 31471168

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Abstract

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). In this prospective observational study, the induction chemotherapy consisted of NabP 125 mg/m2 followed by Gem 1000 mg/m2 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). 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%). Gem/NabP followed by maintenance Gem appears to be safe and effective for older patients with locally advanced or metastatic PC.

Gemcitabine

Maintenance

Nab-paclitaxel

Older adults

Pancreatic cancer

Details

Title: Subtitle: 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
Creators: Roberto Petrioli - University of Siena
Pamela Torre - University of Siena
Guido Pesola - University of Siena
Giovanni Paganini - General Medicine& Oncology, Pieve di Coriano Hospital, ASST Mantova, Italy
Loretta Paolelli - Ospedale Vito Fazzi
Salvatora Tindara Miano - University of Siena
Ignazio Martellucci - University of Siena
Guido Francini - University of Siena
Edoardo Francini - Ospedale Misericordia - Grosseto
Resource Type: Journal article
Publication Details: Journal of geriatric oncology, Vol.11(4), pp.647-651
DOI: 10.1016/j.jgo.2019.08.008
PMID: 31471168
NLM abbreviation: J Geriatr Oncol
ISSN: 1879-4068
eISSN: 1879-4076
Publisher: Elsevier Ltd
Number of pages: 5
Language: English
Date published: 05/01/2020
Academic Unit: Internal Medicine
Record Identifier: 9985221144702771

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