Cancers (Jan 2023)

Treatment Outcomes and Prognostic Factors of Gemcitabine Plus Nab-Paclitaxel as Second-Line Chemotherapy after Modified FOLFIRINOX in Unresectable Pancreatic Cancer

  • Takafumi Mie,
  • Takashi Sasaki,
  • Tsuyoshi Takeda,
  • Takeshi Okamoto,
  • Tsuyoshi Hamada,
  • Takahiro Ishitsuka,
  • Manabu Yamada,
  • Hiroki Nakagawa,
  • Takaaki Furukawa,
  • Akiyoshi Kasuga,
  • Masato Matsuyama,
  • Masato Ozaka,
  • Naoki Sasahira

DOI
https://doi.org/10.3390/cancers15020358
Journal volume & issue
Vol. 15, no. 2
p. 358

Abstract

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Outcomes and prognostic factors of second-line gemcitabine plus nab-paclitaxel (GnP) after modified FOLFIRINOX (mFFX) for unresectable pancreatic cancer were unclear. We retrospectively analyzed consecutive patients with unresectable pancreatic cancer treated with GnP after first-line mFFX treatment between March 2015 and March 2022 at our hospital. A total of 103 patients were included. Median overall survival (OS) from the start of first-line and second-line treatments was 14.9 months and 7.2 months, respectively. Median progression-free survival (PFS) was 3.6 months. Performance status, modified Glasgow prognostic score, and neutrophil-to-lymphocyte ratio were independently associated with OS. Our prognostic model using these parameters classifies patients into good (n = 70) and poor (n = 33) prognosis groups. Median OS and PFS were longer in the good prognosis group than in the poor prognosis group (OS: 9.3 vs. 3.8 months, p p < 0.01). Grade 3/4 adverse events were observed in 70.9% of patients, with neutropenia being the most frequent. While GnP as second-line treatment was well-tolerated, efficacy of second-line gemcitabine plus nab-paclitaxel was notably limited, particularly in the poor prognosis group.

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