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

• Published in: Cancer chemotherapy and pharmacology Vol. 84; no. 3; pp. 647 - 654
• Main Authors: Ishimoto, Utako, Kinoshita, Akiyoshi, Hirose, Yuki, Shibata, Keiko, Ishii, Ayako, Shoji, Ryo, Yokota, Takeharu, Iwaku, Akira, Mizuno, Yusuke, Koike, Kazuhiko, Saruta, Masayuki
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2019; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Albumins - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cancer; Cancer Research; Chemotherapy; Deoxycytidine - administration & dosage; Deoxycytidine - analogs & derivatives; Disease control; Female; Follow-Up Studies; Gemcitabine; Geriatrics; Humans; Liver Neoplasms - drug therapy; Liver Neoplasms - secondary; Lung Neoplasms - drug therapy; Lung Neoplasms - secondary; Lymphatic Metastasis; Male; Medical prognosis; Medicine; Medicine & Public Health; Middle Aged; Multivariate analysis; Neutropenia; Older people; Oncology; Original Article; Paclitaxel; Paclitaxel - administration & dosage; Pancreatic cancer; Pancreatic Neoplasms - drug therapy; Pancreatic Neoplasms - pathology; Patient Safety; Peritoneal Neoplasms - drug therapy; Peritoneal Neoplasms - secondary; Pharmacology/Toxicology; Prognosis; Retrospective Studies; Survival Rate; Treatment Outcome; Gemcitabine; Elderly; Pancreatic cancer; Nab paclitaxel
• ISSN: 0344-5704; 1432-0843
• DOI: 10.1007/s00280-019-03895-2

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.