Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Sunto-gun, Nagaizumi-cho, Shizuoka, 411-8777, Japan.
Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, 060-8543, Japan.
Invest New Drugs. 2022 Oct;40(5):1106-1116. doi: 10.1007/s10637-022-01221-x. Epub 2022 Jul 28.
This study aimed to evaluate the effectiveness and safety of gemcitabine (GEM) plus nab-paclitaxel (GnP) in patients aged ≥ 75 years with advanced pancreatic cancer and compare it with monotherapy (GEM or S-1).
We retrospectively reviewed the data of consecutive patients with advanced pancreatic cancer aged ≥ 75 years who received either GnP or monotherapy (GEM or S-1) between January 2014 and May 2020. The primary efficacy outcome was overall survival (OS).
A total of 96 patients were included in this study; 51 were treated with GnP and 45 with monotherapy (31 with GEM and 14 with S-1). The median OS and progression-free survival were 10.8 and 6.7 months in the GnP group and 10.7 and 4.3 months in the monotherapy group, respectively. The treatment effect on OS was consistently favorable in the GnP group across most subgroups, particularly in patients with locally advanced cancer, modified Glasgow prognostic score of 0 or 1, and neutrophil/lymphocyte ratio < 3.1. The disease control rates were 76% and 48% in the GnP and monotherapy groups, respectively, and grade 3 or 4 neutropenia occurred in 23 (45%) and 11 (24%) patients of the GnP and monotherapy groups, respectively.
This study demonstrated that GnP was not superior to monotherapy with regard to OS. However, multivariate analysis showed that GnP treatment positively affected the OS and could be considered as a treatment option, even for elderly patients.
本研究旨在评估吉西他滨（GEM）联合 nab-紫杉醇（GnP）治疗 75 岁及以上晚期胰腺癌患者的有效性和安全性，并将其与单药治疗（GEM 或 S-1）进行比较。
我们回顾性分析了 2014 年 1 月至 2020 年 5 月期间连续接受 GnP 或单药治疗（GEM 或 S-1）的年龄≥75 岁的晚期胰腺癌患者的数据。主要疗效结局为总生存期（OS）。
本研究共纳入 96 例患者，其中 51 例接受 GnP 治疗，45 例接受单药治疗（31 例 GEM，14 例 S-1）。GnP 组的中位 OS 和无进展生存期分别为 10.8 个月和 6.7 个月，单药组分别为 10.7 个月和 4.3 个月。在 GnP 组，大多数亚组的 OS 治疗效果均较好，特别是局部晚期癌症、改良格拉斯哥预后评分 0 或 1 以及中性粒细胞/淋巴细胞比值<3.1 的患者。GnP 组和单药组的疾病控制率分别为 76%和 48%，GnP 组和单药组分别有 23（45%）和 11（24%）例患者发生 3 级或 4 级中性粒细胞减少。
本研究表明 GnP 在 OS 方面并不优于单药治疗。然而，多变量分析显示 GnP 治疗对 OS 有积极影响，即使对于老年患者，也可将其视为一种治疗选择。
