Article Abstract

First line nab-paclitaxel plus gemcitabine in elderly metastatic pancreatic patients: a good choice beyond age

Authors: Angelica Petrillo, Annalisa Pappalardo, Filomena Calabrese, Giuseppe Tirino, Luca Pompella, Jole Ventriglia, Maria Maddalena Laterza, Marianna Caterino, Vincenzo Sforza, Vega Iranzo, Maria Biglietto, Michele Orditura, Fortunato Ciardiello, Giovanni Conzo, Carlo Molino, Ferdinando De Vita


Background: Nab-paclitaxel plus gemcitabine represents one of the standard regimens for first line treatment of metastatic pancreatic cancer (mPC). Few data are available on nab-paclitaxel plus gemcitabine in geriatric population. Our study aims to show whether this schedule can be feasible in the elderly as first-line treatment for mPC.
Methods: We retrospectively analyzed the data of 64 mPC patients (≥65 years old) treated according to the MPACT schedule.
Results: Median age was 69.5 years (range, 65–80 years); after a median of 5 cycles administered (range, 1–12), the most common adverse events (AEs) were grade 2 alopecia (46.9%), anemia (17.2%) and hypertransaminasemia (10.9%); all grades neutropenia occurred in 20.3% of pts. Global incidence of grade 3 and 4 toxicities were 26.5% and 0%, respectively, and no patients stopped treatment due to unacceptable toxicity. Stable disease (SD) was observed in 31.2% of patients, with a disease control rate (DCR) and overall response rate of 57.8% and 26.6%, respectively. After a median follow-up of 18 months, median progression free survival (PFS) was 8 months (95% CI: 6.3–9.6) and median OS was 12.0 months (95% CI: 8.4–15.6). The univariate analysis for overall survival (OS) showed that only ECOG performance status was an independent prognostic factor for survival.
Conclusions: Nab-paclitaxel plus gemcitabine schedule is feasible and effective in the “daily clinical practice” geriatric population.

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