Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
, 113 (7), 989-95

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

Affiliations
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.

Abstract

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.

Figures

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.

Comment in

Similar articles

See all similar articles

Cited by 40 articles

See all "Cited by" articles

References

    1. Assaf E, Verlinde-Carvalho M, Delbaldo C, Grenier J, Sellam Z, Pouessel D, Bouaita L, Baumgaertner I, Sobhani I, Tayar C, Paul M, Culine S (2011) 5-fluorouracil/leucovorin combined with irinotecan and oxaliplatin (FOLFIRINOX) as second-line chemotherapy in patients with metastatic pancreatic adenocarcinoma. Oncology 80: 301–306. - PubMed
    1. Bachet J-B, Mitry E, Lièvre A, Lepère C, Vaillant J-N, Declety G, Parlier H, Emile J-F, Julié C, Rougier P (2009) Second- and third-line chemotherapy in patients with metastatic pancreatic adenocarcinoma: feasibility and potential benefits in a retrospective series of 117 patients. Gastroenterol Clin Biol 33: 1036–1044. - PubMed
    1. Bonnetain F, Bonsing B, Conroy T, Dousseau A, Glimelius B, Haustermans K, Lacaine F, Van Laethem JL, Aparicio T, Aust D, Bassi C, Berger V, Chamorey E, Chibaudel B, Dahan L, De Gramont A, Delpero JR, Dervenis C, Ducreux M, Gal J, Gerber E, Ghaneh P, Hammel P, Hendlisz A, Jooste V, Labianca R, Latouche A, Lutz M, Macarulla T, Malka D, Mauer M, Mitry E, Neoptolemos J, Pessaux P, Sauvanet A, Tabernero J, Taieb J, van Tienhoven G, Gourgou-Bourgade S, Bellera C, Mathoulin-Pélissier S, Collette L (2014) Guidelines for time-to-event end-point definitions in trials for pancreatic cancer. Results of the DATECAN initiative (Definition for the Assessment of Time-to-event End-points in CANcer trials). Eur J Cancer 50: 2983–2993. - PubMed
    1. Conroy T, Desseigne F, Ychou M, Bouché O, Guimbaud R, Bécouarn Y, Adenis A, Raoul J-L, Gourgou-Bourgade S, de la Fouchardière C, Bennouna J, Bachet J-B, Khemissa-Akouz F, Péré-Vergé D, Delbaldo C, Assenat E, Chauffert B, Michel P, Montoto-Grillot C, Ducreux M Groupe Tumeurs Digestives of UnicancerPRODIGE Intergroup (2011) FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med 364: 1817–1825. - PubMed
    1. Dahan L, Bonnetain F, Ychou M, Mitry E, Gasmi M, Raoul J-L, Cattan S, Phelip J-M, Hammel P, Chauffert B, Michel P, Legoux J-L, Rougier P, Bedenne L, Seitz J-F Fédération Francophone de Cancérologie Digestive (2010) Combination 5-fluorouracil, folinic acid and cisplatin (LV5FU2-CDDP) followed by gemcitabine or the reverse sequence in metastatic pancreatic cancer: final results of a randomised strategic phase III trial (FFCD 0301). Gut 59: 1527–1534. - PMC - PubMed

MeSH terms

Supplementary concepts

Feedback