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The efficacy and safety of nab paclitaxel plus gemcitabine in elderly patients over 75 years with unresectable pancreatic cancer compared with younger patients

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Abstract

Purpose

To evaluate the efficacy and safety of nab paclitaxel (nab-P) plus gemcitabine (GEM) in elderly patients ≥ 75 years old with unresectable pancreatic cancer (PC) compared with younger patients.

Methods

The data of 27 unresectable PC patients treated with nab-P plus GEM as first-line chemotherapy were retrospectively analyzed. The patients were divided into two groups according to their age at inclusion: an elderly group (9 patients ≥ 75 years old) and a younger group (18 patients <75 years old). We compared the disease control rate, median overall survival (OS), and adverse events (AEs) between the two groups. Predictive factors for the OS were also evaluated.

Results

The clinical characteristics of patients of the two groups were not significantly different except for the age. The respective values for the disease control rate (66.7% vs. 77.8%, P = 0.542) and median OS (277 days vs. 312 days, P = 0.722) were also not significantly different between the elderly and younger group, although the relative dose intensity of GEM/nab-P in the elderly group (56.6%/53.1%) was significantly lower than that in the younger group (67.3%/63.1%) (P = 0.016/0.04). The absence of biliary drainage and CEA ≥ 6.5 were found to be poor prognostic factors in a multivariate analysis. The most common grade ≥ 3 AE was neutropenia (44% in both groups). No significant differences in the frequency of all AEs were observed between the two groups.

Conclusions

Nab-P plus GEM appears effective and well-tolerated for elderly patients ≥ 75 years old with unresectable PC.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, The Jikei University Daisan Hospital, 4-11-1 Izumihon-cho, Komae-shi, Tokyo, 201-8601, Japan

    Utako Ishimoto, Akiyoshi Kinoshita, Yuki Hirose, Keiko Shibata, Ayako Ishii, Ryo Shoji, Takeharu Yokota, Akira Iwaku, Yusuke Mizuno & Kazuhiko Koike

  2. Division of Gastroenterology and Hepatology, Department of Internal Medicine, the Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105-8461, Japan

    Masayuki Saruta

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  1. Utako Ishimoto
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Correspondence to Akiyoshi Kinoshita.

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All the procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Written informed consent for participation in this study was not obtained from the patients because this study was not designed to be a clinical trial and the data were collected retrospectively and analyzed anonymously.

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Ishimoto, U., Kinoshita, A., Hirose, Y. et al. The efficacy and safety of nab paclitaxel plus gemcitabine in elderly patients over 75 years with unresectable pancreatic cancer compared with younger patients. Cancer Chemother Pharmacol 84, 647–654 (2019). https://doi.org/10.1007/s00280-019-03895-2

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