Gemcitabine/nab-paclitaxel as second-line therapy following FOLFIRINOX in metastatic/advanced pancreatic cancer- retrospective analysis of response

Khanh T. Nguyen, Aparna Kalyan, H. Scott Beasley, Aatur D. Singhi, Weijing Sun, Herbert J. Zeh, Daniel Normolle, Nathan Bahary

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: Given the tolerability of nPG in first-line therapy, we desired to evaluate the response and toxicity profiles of second-line gemcitabine with nab-paclitaxel (nPG) following FOLFIRINOX. Methods: We retrospectively identified 30 patients who received first-line FOLFIRINOX for unresectable or metastatic pancreatic adenocarcinoma followed by second-line nPG. Response was evaluated by RECIST criteria and carbohydrate antigen 19-9 (CA19-9) change. Results: Median age was 63 years with 77% percent having metastatic disease. Nineteen patients (63%) achieved PR based on CA19-9. Median overall survival (OS) with nPG was 12.4 months (mo) and median progression-free survival (PFS) was 3.8 mo. Median PFS and OS for patients with at least stable CA19-9 were 4.7 and 14 mo since initiation of nPG. Patients with an increased CA19-9 level during nPG had a shorter median PFS (1.4 mo) and OS (5.4 mo). A significant PFS difference was demonstrated in patients with at least stable disease as the best RECIST response versus in those with progressive disease (5.5 vs. 1.9 mo, P < 0.001). Grade 3/4 adverse events include thrombocytopenia (33%), anemia (23%), nausea (17%), lymphopenia (7%), infectious complications (6%), diarrhea (3%), and neuropathy (3%). Conclusions: This study demonstrates a clinical benefit of second-line nPG. The study also suggests a possible use of CA19-9 to predict response to therapy

Original languageEnglish (US)
Pages (from-to)556-565
Number of pages10
JournalJournal of Gastrointestinal Oncology
Volume8
Issue number3
DOIs
StatePublished - Jun 1 2017
Externally publishedYes

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gemcitabine
Pancreatic Neoplasms
Carbohydrates
Disease-Free Survival
Antigens
Survival
Therapeutics
Lymphopenia
Thrombocytopenia
Nausea
Anemia
Diarrhea
Adenocarcinoma
130-nm albumin-bound paclitaxel

Keywords

  • Carbohydrate antigen 19-9 (CA19-9)
  • FOLFIRINOX
  • Gemcitabine
  • Nab-paclitaxel
  • Pancreatic cancer

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology

Cite this

Gemcitabine/nab-paclitaxel as second-line therapy following FOLFIRINOX in metastatic/advanced pancreatic cancer- retrospective analysis of response. / Nguyen, Khanh T.; Kalyan, Aparna; Scott Beasley, H.; Singhi, Aatur D.; Sun, Weijing; Zeh, Herbert J.; Normolle, Daniel; Bahary, Nathan.

In: Journal of Gastrointestinal Oncology, Vol. 8, No. 3, 01.06.2017, p. 556-565.

Research output: Contribution to journalArticle

Nguyen, Khanh T. ; Kalyan, Aparna ; Scott Beasley, H. ; Singhi, Aatur D. ; Sun, Weijing ; Zeh, Herbert J. ; Normolle, Daniel ; Bahary, Nathan. / Gemcitabine/nab-paclitaxel as second-line therapy following FOLFIRINOX in metastatic/advanced pancreatic cancer- retrospective analysis of response. In: Journal of Gastrointestinal Oncology. 2017 ; Vol. 8, No. 3. pp. 556-565.
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abstract = "Background: Given the tolerability of nPG in first-line therapy, we desired to evaluate the response and toxicity profiles of second-line gemcitabine with nab-paclitaxel (nPG) following FOLFIRINOX. Methods: We retrospectively identified 30 patients who received first-line FOLFIRINOX for unresectable or metastatic pancreatic adenocarcinoma followed by second-line nPG. Response was evaluated by RECIST criteria and carbohydrate antigen 19-9 (CA19-9) change. Results: Median age was 63 years with 77{\%} percent having metastatic disease. Nineteen patients (63{\%}) achieved PR based on CA19-9. Median overall survival (OS) with nPG was 12.4 months (mo) and median progression-free survival (PFS) was 3.8 mo. Median PFS and OS for patients with at least stable CA19-9 were 4.7 and 14 mo since initiation of nPG. Patients with an increased CA19-9 level during nPG had a shorter median PFS (1.4 mo) and OS (5.4 mo). A significant PFS difference was demonstrated in patients with at least stable disease as the best RECIST response versus in those with progressive disease (5.5 vs. 1.9 mo, P < 0.001). Grade 3/4 adverse events include thrombocytopenia (33{\%}), anemia (23{\%}), nausea (17{\%}), lymphopenia (7{\%}), infectious complications (6{\%}), diarrhea (3{\%}), and neuropathy (3{\%}). Conclusions: This study demonstrates a clinical benefit of second-line nPG. The study also suggests a possible use of CA19-9 to predict response to therapy",
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T1 - Gemcitabine/nab-paclitaxel as second-line therapy following FOLFIRINOX in metastatic/advanced pancreatic cancer- retrospective analysis of response

AU - Nguyen, Khanh T.

AU - Kalyan, Aparna

AU - Scott Beasley, H.

AU - Singhi, Aatur D.

AU - Sun, Weijing

AU - Zeh, Herbert J.

AU - Normolle, Daniel

AU - Bahary, Nathan

PY - 2017/6/1

Y1 - 2017/6/1

N2 - Background: Given the tolerability of nPG in first-line therapy, we desired to evaluate the response and toxicity profiles of second-line gemcitabine with nab-paclitaxel (nPG) following FOLFIRINOX. Methods: We retrospectively identified 30 patients who received first-line FOLFIRINOX for unresectable or metastatic pancreatic adenocarcinoma followed by second-line nPG. Response was evaluated by RECIST criteria and carbohydrate antigen 19-9 (CA19-9) change. Results: Median age was 63 years with 77% percent having metastatic disease. Nineteen patients (63%) achieved PR based on CA19-9. Median overall survival (OS) with nPG was 12.4 months (mo) and median progression-free survival (PFS) was 3.8 mo. Median PFS and OS for patients with at least stable CA19-9 were 4.7 and 14 mo since initiation of nPG. Patients with an increased CA19-9 level during nPG had a shorter median PFS (1.4 mo) and OS (5.4 mo). A significant PFS difference was demonstrated in patients with at least stable disease as the best RECIST response versus in those with progressive disease (5.5 vs. 1.9 mo, P < 0.001). Grade 3/4 adverse events include thrombocytopenia (33%), anemia (23%), nausea (17%), lymphopenia (7%), infectious complications (6%), diarrhea (3%), and neuropathy (3%). Conclusions: This study demonstrates a clinical benefit of second-line nPG. The study also suggests a possible use of CA19-9 to predict response to therapy

AB - Background: Given the tolerability of nPG in first-line therapy, we desired to evaluate the response and toxicity profiles of second-line gemcitabine with nab-paclitaxel (nPG) following FOLFIRINOX. Methods: We retrospectively identified 30 patients who received first-line FOLFIRINOX for unresectable or metastatic pancreatic adenocarcinoma followed by second-line nPG. Response was evaluated by RECIST criteria and carbohydrate antigen 19-9 (CA19-9) change. Results: Median age was 63 years with 77% percent having metastatic disease. Nineteen patients (63%) achieved PR based on CA19-9. Median overall survival (OS) with nPG was 12.4 months (mo) and median progression-free survival (PFS) was 3.8 mo. Median PFS and OS for patients with at least stable CA19-9 were 4.7 and 14 mo since initiation of nPG. Patients with an increased CA19-9 level during nPG had a shorter median PFS (1.4 mo) and OS (5.4 mo). A significant PFS difference was demonstrated in patients with at least stable disease as the best RECIST response versus in those with progressive disease (5.5 vs. 1.9 mo, P < 0.001). Grade 3/4 adverse events include thrombocytopenia (33%), anemia (23%), nausea (17%), lymphopenia (7%), infectious complications (6%), diarrhea (3%), and neuropathy (3%). Conclusions: This study demonstrates a clinical benefit of second-line nPG. The study also suggests a possible use of CA19-9 to predict response to therapy

KW - Carbohydrate antigen 19-9 (CA19-9)

KW - FOLFIRINOX

KW - Gemcitabine

KW - Nab-paclitaxel

KW - Pancreatic cancer

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