Relative dose intensity of gemcitabine-nab-paclitaxel combination as second-line or more in locally advanced or metastatic pancreatic adenocarcinoma - 28/03/25
, Leila Tagemouati 1, ⁎, André Gillibert 2, Lilian Schwarz 3, Virginie Vernon 1, David Sefrioui 1, Pierre Michel 1, Marie Dutherage 1, Frédéric Di Fiore 1Cet article a été publié dans un numéro de la revue, cliquez ici pour y accéder
Highlights |
• | Relative dose intensity (RDI) of gemzar-nab-paclitaxel (GNP) has not been reported in second line and more in advanced pancreatic carcinoma. |
• | The RDI is relatively low with 50% of patients who received GNP at a RDI ≥70% during the first months of treatment resulting of treatment schedule modification in two third of cases and a full dose in only 15%. |
• | There was no significant difference in prognosis between RDI<70% and ≥70% supporting that alternative GNP regimens may be of interest in that setting. |
Abstract |
Background |
Gemcitabine-nab-paclitaxel (GNP) is widely used in treating advanced or metastatic pancreatic adenocarcinoma (a/mPA), but no data are available regarding its relative dose intensity (RDI) beyond the first line.
Aim |
To assess the impact of the RDI of GNP as second-line or greater therapy (L2+) for a/mPA.
Methods |
Patients with a/mPA undergoing L2+ treatment were retrospectively included. The RDI was analysed from the start of GNP to the first CT scan. Overall survival (OS), progression-free survival (PFS) and toxicity were analysed according to the RDI at a predefined threshold of 70%.
Results |
A total of 116 patients were included, with a median RDI of 70% (range, 20%-114%). There was no significant difference in OS or PFS between RDI<70% and ≥70%, with median of 7.0 and 8.1 months (adjusted HR = 1.35; CI95% [0.89-2.05]; p=0.2) and 3.1 vs 3.4 months (adjusted HR = 1.36; CI95% [0.91-2.05]; p=0.14), respectively. Grade ≥3 toxicities were more common in RDI <70% as compared to RDI ≥70% (56.9% vs. 37.9%, p=0.04) and responsible for more GNP dose reductions (67.7% vs. 50%, p= 0.13) and schedule modifications (72.4% vs. 48.2%, p = 0.008).
Conclusion |
Our results suggest that the level of GNP exposure, at a predefined RDI threshold of 70%, had no significant effect on survival in our patients treated in L2+ for a a/mPA. Alternative GNP regimens may be evaluated in patients undergoing L2+ treatment for a/mPA.
Le texte complet de cet article est disponible en PDF.Keywords : Pancreatic cancer, gemcitabine, nab-paclitaxel, relative dose intensity
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