Department of Medical Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
4+4 Medical Doctor Program, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Cancer Biol Med. 2023 Aug 29;20(10):765-78. doi: 10.20892/j.issn.2095-3941.2023.0189.
Gemcitabine plus nab-paclitaxel (GnP) is the standard first-line therapy for advanced pancreatic ductal adenocarcinoma (PDAC). S-1, an oral fluoropyrimidine derivative, as compared with gemcitabine, is non-inferior in terms of overall survival (OS) and is associated with lower hematologic toxicity. Accordingly, S-1 is a convenient oral alternative treatment for advanced PDAC. This study was aimed at comparing the efficacy and safety of gemcitabine plus S-1 (GS) GnP as first-line chemotherapy for advanced PDAC.
Patients with advanced PDAC who received first-line GS or GnP at the Peking Union Medical College Hospital between March 2011 and November 2022 were evaluated.
A total of 300 patients were assessed, of whom 84 received GS and 216 received GnP. The chemotherapy completion rate was higher with GS than GnP (50.0% 30.3%, = 0.0028). The objective response rate (ORR) was slightly higher (14.3% 9.7%, = 0.35), and the median OS was significantly longer (17.9 months 13.3 months, = 0.0078), in the GS group than the GnP group. However, the median progression-free survival (PFS) did not significantly differ between groups. Leukopenia risk was significantly lower in the GS group than the GnP group (14.9% 28.1%, = 0.049).
As first-line chemotherapy for advanced PDAC, the GS regimen led to a significantly longer OS than the GnP regimen. The PFS, ORR, and incidence of severe adverse events were comparable between the GS and GnP groups.
吉西他滨联合 nab-紫杉醇（GnP）是晚期胰腺导管腺癌（PDAC）的标准一线治疗方案。替吉奥（S-1）是一种口服氟嘧啶衍生物，其总生存期（OS）与吉西他滨相当，但血液学毒性较低。因此，S-1 是晚期 PDAC 一种方便的口服替代治疗方法。本研究旨在比较吉西他滨联合 S-1（GS）和 GnP 作为晚期 PDAC 一线化疗的疗效和安全性。
评估 2011 年 3 月至 2022 年 11 月期间在北京协和医院接受一线 GS 或 GnP 治疗的晚期 PDAC 患者。
共评估了 300 例患者，其中 84 例接受 GS 治疗，216 例接受 GnP 治疗。GS 组的化疗完成率高于 GnP 组（50.0% vs. 30.3%， = 0.0028）。GS 组的客观缓解率（ORR）略高（14.3% vs. 9.7%， = 0.35），中位 OS 明显更长（17.9 个月 vs. 13.3 个月， = 0.0078）。然而，两组的中位无进展生存期（PFS）无显著差异。GS 组的白细胞减少风险明显低于 GnP 组（14.9% vs. 28.1%， = 0.049）。
作为晚期 PDAC 的一线化疗方案，GS 方案的 OS 明显长于 GnP 方案。GS 和 GnP 组的 PFS、ORR 和严重不良事件发生率相当。
