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Multicenter Study
, 113 (7), 989-95

Nab-paclitaxel Plus Gemcitabine for Metastatic Pancreatic Adenocarcinoma After Folfirinox Failure: An AGEO Prospective Multicentre Cohort

Multicenter Study

Nab-paclitaxel Plus Gemcitabine for Metastatic Pancreatic Adenocarcinoma After Folfirinox Failure: An AGEO Prospective Multicentre Cohort

Alix Portal et al. Br J Cancer.


Background: There is currently no standard second-line treatment for metastatic pancreatic adenocarcinoma (MPA), and progression-free survival is consistently <4 months in this setting. The aim of this study was to evaluate the efficacy and tolerability of Nab-paclitaxel plus gemcitabine (A+G) after Folfirinox failure in MPA.

Methods: From February 2013 to July 2014, all consecutive patients treated with A+G for histologically proven MPA after Folfirinox failure were prospectively enrolled in 12 French centres. A+G was delivered as described in the MPACT trial, until disease progression, patient refusal or unacceptable toxicity.

Results: Fifty-seven patients were treated with Nab-paclitaxel plus gemcitabine, for a median of 4 cycles (range 1-12). The disease control rate was 58%, with a 17.5% objective response rate. Median overall survival (OS) was 8.8 months (95% CI: 6.2-9.7) and median progression-free survival was 5.1 months (95% CI: 3.2-6.2). Since the start of first-line chemotherapy, median OS was 18 months (95% CI: 16-21). No toxic deaths occurred. Grade 3-4 toxicities were reported in 40% of patients, consisting of neutropenia (12.5%), neurotoxicity (12.5%), asthenia (9%) and thrombocytopenia (6.5%).

Conclusions: A+G seems to be effective, with a manageable toxicity profile, after Folfirinox failure in patients with MPA.


Figure 1
Figure 1
OS and PFS.
Figure 2
Figure 2
OS and PFS since the beginning of first-line chemotherapy. OS1+2: Overall survival since the beginning of first-line chemotherapy. PFS1+2: Progression-free survival since the beginning of first-line chemotherapy.

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