Comparison of nab-paclitaxel plus gemcitabine in elderly versus younger patients with metastatic pancreatic cancer: Analysis of a multicentre, prospective, non-interventional study

Prager, Gerald W.; Oehler, Leopold; Gerger, Armin; Mlineritsch, Brigitte; Andel, Johannes; Petzer, Andreas; Wilthoner, Klaus; Sliwa, Thamer; Pichler, Petra; Winder, Thomas; Heibl, Sonja; Gruenberger, Birgit; Laengle, Friedrich; Hubmann, Eva; Korger, Markus; Pecherstorfer, Martin; Djanani, Angela; Neumann, H; Philipp‐Abbrederis, Kathrin; Wöll, Ewald; Trondl, Robert; Arnold-Schrauf, Catharina; Eisterer, Wolfgang

doi:10.1016/j.ejca.2020.11.003

Cited by 20 publications

(23 citation statements)

References 34 publications

(41 reference statements)

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“…In contrast to OS, no difference was seen in PFS in patients older than 65 years. Similarly, no difference in median PFS was recently reported in a non-interventional study by Prager et al [ 22 ] where patients receiving nab-P/Gem were stratified by age. The median PFS was 5.55 and 5.52 months for patients ≤70 and >70, respectively.…”

Section: Discussionmentioning

confidence: 73%

“…with gemcitabine monotherapy than with Nab-P/Gem (Table 1 ). Unfortunately, gemcitabine alone has very limited value in mPDAC treatment [ 13 , 22 , 24 ] and the patients’ general condition is recognized as an independent negative predictive factor for survival. [ 14 , 15 , 21 ] With that in mind, a more intensive therapeutic approach appears to offer greater survival benefits in patients with more advanced p.s.…”

Section: Discussionmentioning

confidence: 99%

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The effectiveness of nab-paclitaxel plus gemcitabine and gemcitabine monotherapy in first-line metastatic pancreatic cancer treatment: A real-world evidence

et al. 2022

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Pancreatic cancer is one of the most lethal malignancies with a rise in mortality rates. FOLFIRINOX and nab-paclitaxel plus gemcitabine demonstrated a survival benefit compared to gemcitabine alone. Both protocols are now considered the standard of first-line treatment with no significant difference between them, primarily based on observational studies. Although new therapeutic options have emerged recently, the prognosis remains poor. We conducted a retrospective single-center study on 139 patients treated for metastatic pancreatic adenocarcinoma (mPDAC) with gemcitabine monotherapy (Gem) or nab-paclitaxel + gemcitabine (Nab-P/Gem) in the first line. The aim of our study was to evaluate the effectiveness in terms of overall survival (OS) and progression-free survival (PFS) as well as the influence of patient and disease characteristics on outcomes. Nab-P/Gem resulted in OS of 13.87 months compared to 8.5 months in patients receiving Gem. The same trend was achieved in PFS, 5.37 versus 2.80 months, respectively, but without reaching statistical significance. Furthermore, the 6-month survival in the Nab-P/Gem group was also higher, 78.1% versus 47.8%. In terms of survival, the group of elderly patients, patients of poorer performance, with higher metastatic burden and liver involvement, benefited the most from combination therapy. In our analysis ECOG performance status (p.s.), previous primary tumor surgery, and liver involvement were found to be independent prognostic factors. The addition of nab-paclitaxel to gemcitabine resulted in a significant improvement in the OS of patients with mPDAC. Subgroup analysis demonstrated that patients with some unfavorable prognostic factors benefited the most.

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

The effectiveness of nab-paclitaxel plus gemcitabine and gemcitabine monotherapy in first-line metastatic pancreatic cancer treatment: A real-world evidence

et al. 2022

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“… 26 Notably, only 16.4% of the study cohort in the reviewed literature were aged ⩾70 years, suggesting that the number of older patients was insufficient in most clinical trial settings. Additionally, a prospective study by Prager et al 27 showed that older and younger patients with metastatic pancreatic cancer had comparable ORR, PFS, and OS, although fatigue and decreased appetite were more frequent in older patients. More importantly, 1 study by Trumper et al 12 analyzed 1080 patients with gastric cancer from 3 clinical trials and demonstrated that age was not an independent prognostic factor for OS.…”

Section: Discussionmentioning

confidence: 99%

Chemotherapy for Metastatic Gastric Cancer: Does Age Matter? A Single-Center, Retrospective, Real-World Study

Liao

Cheng

Chou

et al. 2022

Clin Med Insights Oncol

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Background: Palliative chemotherapy is the preferred standard of care for patients with metastatic gastric cancer (mGC). It remains uncertain whether older patients with mGC would benefit from palliative chemotherapy. This study aimed to investigate the clinical impact of palliative chemotherapy in older patients with mGC. Methods: This single-institute, retrospective, and real-world study included 428 patients with mGC between January 2009 and December 2019. Among them, 306 who received palliative chemotherapy were further stratified into 2 groups according to age: ≤70 (n = 236) and >70 (n = 70) years. The clinical demographics, outcomes, and hematologic toxicities of chemotherapy were compared between the 2 groups. Prognostic factors were determined using the Cox proportional hazards model. Results: Of the screened 428 patients, older patients had worse overall survival (OS) than younger patients. Among patients who received chemotherapy (n = 306), patients aged >70 and ⩽70 years had comparable progression-free survival (PFS) and OS. The incidence of severe hematologic toxicity was similar between the 2 groups. The Eastern Cooperative Oncology Group performance status of 2 or more metastatic sites, elevated carbohydrate antigen 19-9 level, high neutrophil-to-lymphocyte ratio (NLR), and undergoing palliative gastrectomy were independent prognostic factors for OS. Notably, age >70 years was not a significant factor for poor OS. Conclusions: Older age of >70 years might not be considered an obstacle to administering palliative chemotherapy to patients with mGC.

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“…These clinical trials and studies can be grouped into four categories: 1. Continued testing of GnP in different groups of patients with advanced pancreatic cancer, such as elderly patients and patients with poor physical performance ( 87 – 89 ); 2. Comparing the efficacy and safety of GnP with FOLFIRINOX (a conventional chemotherapy regimen) for pancreatic cancer ( 90 – 93 ); 3.…”

Section: Efficacy Of Nab-paclitaxel In Non-sarcoma Malignanciesmentioning

confidence: 99%

Albumin-Bound Paclitaxel: Worthy of Further Study in Sarcomas

Tian

Yao

2022

Front. Oncol.

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Taxanes (paclitaxel and docetaxel) play an important role in the treatment of advanced sarcomas. Albumin-bound paclitaxel (nab-paclitaxel) is a new kind of taxane and has many advantages compared with paclitaxel and docetaxel. Nab-paclitaxel is currently approved for the treatment of advanced breast, non-small cell lung, and pancreatic cancers. However, the efficacy of nab-paclitaxel in sarcomas has not been reviewed. In this review, we first compare the similarities and differences among nab-paclitaxel, paclitaxel, and docetaxel and then summarize the efficacy of nab-paclitaxel against various non-sarcoma malignancies based on clinical trials with reported results. The efficacy and clinical research progress on nab-paclitaxel in sarcomas are also summarized. This review will serve as a good reference for the application of nab-paclitaxel in clinical sarcoma treatment studies and the design of clinical trials.

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Comparison of nab-paclitaxel plus gemcitabine in elderly versus younger patients with metastatic pancreatic cancer: Analysis of a multicentre, prospective, non-interventional study

Cited by 20 publications

References 34 publications

The effectiveness of nab-paclitaxel plus gemcitabine and gemcitabine monotherapy in first-line metastatic pancreatic cancer treatment: A real-world evidence

The effectiveness of nab-paclitaxel plus gemcitabine and gemcitabine monotherapy in first-line metastatic pancreatic cancer treatment: A real-world evidence

Chemotherapy for Metastatic Gastric Cancer: Does Age Matter? A Single-Center, Retrospective, Real-World Study

Albumin-Bound Paclitaxel: Worthy of Further Study in Sarcomas

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