Real-world predictive models for survival with nab-paclitaxel plus gemcitabine in metastatic pancreatic cancer

Introduction:
In 2020 in Poland a total of 3 589 people had pancreatic cancer (PC). Only 20% of patients were diagnosed with surgical disease. New therapeutic options that demonstrate statistically significant improvements in overall survival (OS) and progression-free survival (PFS) are still being sought. 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.

Material and methods:
The aim of the clinical study was a retrospective analysis of the medical history of 182 patients with the diagnosis of metastatic pancreatic cancer (mPC), who were treated with combination treatment of nab-paclitaxel with gemcitabine (GEM-NAB) between February 2017 and September 2023. Our study also aimed to identify important population-based predictors for survival in patients diagnosed with mPC.

Results:
The median age was 66 years (range 37–84 years). Median OS was 9.2 months (95% CI: 8.3–10.03), and median PFS was 5.47 months (95% CI: 4.83–6.1); 26 patients achieved either a partial or complete response (overall response rate 14%). GEM-NAB was well tolerated. The most common adverse events were alopecia, fatigue, neutropenia, anemia, and peripheral neuropathy. This study identified specific clinical and laboratory parameters (neutrophil to lymphocyte ratio, antigen Ca 19.9, mechanical jaundice, peripheral neuropathy and 2^nd and 3^rd lines of treatment) as independent prognostic factors.

Conclusions:
Our results confirm the efficacy and tolerability of GEM-NAB as standard first-line treatment in patients with mPC. Among the factors having the greatest impact on OS was the 3^rd line of treatment, and for PFS the presence of peripheral neuropathy.