Gemcitabine plus nab-paclitaxel improves survival in pancreatic cancer
For patients with metastatic pancreatic cancer, combining gemcitabine with nanoparticle albumin-bound (nab)-paclitaxel improves survival over the standard first-line therapy of gemcitabine alone.
In an international trial published online (New England Journal of Medicine 16 October 2013), 861 patients with previously untreated metastatic pancreatic cancer received either gemcitabine plus nab-paclitaxel or gemcitabine alone, with treatment continuing until disease progression. Median overall survival was 8.5 months in the combination group and 6.7 months with gemcitabine alone (hazard ratio for death 0.72, 95 per cent confidence interval 0.62-0.83; P<0.001).
The one-year and two-year survival rates were significantly higher with the combination than gemcitabine alone: 35 per cent vs 22 per cent, and 9 per cent vs 4 per cent.
Rates of myelosuppression and peripheral neuropathy were increased in the paclitaxel-gemcitabine group.
The researchers note that the improved survival was not as good as that reported previously with a FOLFIRINOX (oxaliplatin, irinotecan, fluorouracil and leucovorin) regimen, in which median survival improved by 4.3 months over gemcitabine, but say that their patients were older and had poorer performance status.
Celgene has applied to the European Medicines Agency for a licence for use of nab-paclitaxel (Abraxane) in metastatic pancreatic cancer.
Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2013.11129176