Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Department of Radiology, Yonsei University College of Medicine, Seoul, Korea.
Semin Oncol. 2017 Dec;44(6):420-427. doi: 10.1053/j.seminoncol.2018.01.001. Epub 2018 Jan 12.
Pancreatic cancer has poor prognosis because of its rapid progression and treatment resistance. Based on the results of the Metastatic Pancreatic Adenocarcinoma Clinical Trial (MPACT), a combination regimen of gemcitabine with nab-paclitaxel is currently used as standard therapy for the treatment of metastatic pancreatic cancer. However, because studies in Asian populations are lacking, we investigated the treatment efficacy and safety of this combination therapy in Korean population. Patients with metastatic pancreatic cancer (n=81) treated with gemcitabine and nab-paclitaxel (1,000 and 125 mg/m, respectively) as the first-line chemotherapy from January 2016 were identified using the Severance Hospital Pancreatic Cancer Cohort Registry. Treatment efficacy and treatment-related adverse events (AEs) were analyzed. The median follow-up period was 10.7 months (range, 1.5-23.3 months). Median overall survival, progression-free survival, and objective response rates were 12.1 months (95% confidence interval [CI], 10.7-not estimable), 8.4 months (95% CI, 5.0-11.8), and 46.9%, respectively. The incidence of grade ≥3 neurotoxicity and neutropenia were 18.5% and 46.9%, respectively. Febrile neutropenia and grade ≥3 gastrointestinal AEs occurred in 13 (16.0%) and 16 (19.8%) patients, respectively. Dose reductions because of AEs were required in 60.5% of patients. The combination of gemcitabine with nab-paclitaxel is an effective anti-cancer regimen in Korean population of patients with metastatic pancreatic adenocarcinoma. However, careful monitoring and management are required because of occurrence of treatment-related AEs.
胰腺癌由于其快速进展和治疗耐药性,预后较差。基于转移性胰腺腺癌临床试验(MPACT)的结果,吉西他滨联合 nab-紫杉醇联合方案目前被用作转移性胰腺癌的标准治疗。然而,由于缺乏亚洲人群的研究,我们在韩国人群中研究了这种联合治疗的疗效和安全性。使用 Severance 医院胰腺癌队列登记处,确定了 81 例转移性胰腺癌患者(n=81),这些患者在 2016 年 1 月接受吉西他滨和 nab-紫杉醇(分别为 1000mg/m 和 125mg/m)作为一线化疗。分析了治疗效果和治疗相关不良反应(AE)。中位随访时间为 10.7 个月(范围,1.5-23.3 个月)。中位总生存期、无进展生存期和客观缓解率分别为 12.1 个月(95%置信区间[CI],10.7-不可估计)、8.4 个月(95%CI,5.0-11.8)和 46.9%。≥3 级神经毒性和中性粒细胞减少的发生率分别为 18.5%和 46.9%。发热性中性粒细胞减少症和≥3 级胃肠道 AE 分别发生在 13(16.0%)和 16(19.8%)例患者中。由于 AE 而需要减少剂量的患者占 60.5%。吉西他滨联合 nab-紫杉醇在韩国转移性胰腺腺癌患者中是一种有效的抗癌方案。然而,由于发生治疗相关 AE,需要密切监测和管理。