(Pancreatic Cancer) Efficacy of Gemzar + Abraxane?

• October 31, 2019
• Reading time: 2 minutes

Updated: December 20, 2019

At the European Society for Medical Oncology (ESMO) Annual Meeting held in Barcelona, Spain from September 27 to October 1, 2019, Volker Kunzmann presented results from the NEOLAP Phase II clinical trial evaluating the efficacy and safety of gemcitabine plus nab-paclitaxel (Gemzar + Abraxane) combination therapy in previously untreated locally advanced pancreatic cancer patients.

The NEOLAP Phase II trial was an open-label, randomized, prospective study. After two cycles of gemcitabine plus nab-paclitaxel induction therapy, patients were randomized in a 1:1 ratio to continue gemcitabine plus nab-paclitaxel (2 more cycles, N=64) or switch to FOLFIRINOX therapy (4 cycles, N=66).

Approximately 30% of locally advanced pancreatic cancer patients are recommended induction chemotherapy, but the optimal regimen remains unclear. This trial compared gemcitabine plus nab-paclitaxel and FOLFIRINOX in previously untreated patients.

Results:

Primary endpoint conversion rate: gemcitabine + nab-paclitaxel group 30.6% / FOLFIRINOX group 45.0%.

Secondary endpoint median OS: gemcitabine + nab-paclitaxel group 17.2 months / FOLFIRINOX group 22.5 months. The FOLFIRINOX group showed a 27% reduction in mortality risk (HR 0.73), but this was not statistically significant.

Median OS by conversion achievement: converted patients 27.4 months / non-converted patients 14.2 months, with a 55% reduction in mortality risk (HR 0.45) — a significant improvement.

Safety:

Grade ≥3 adverse events: gemcitabine + nab-paclitaxel group 54.7% / FOLFIRINOX group 53.0%.

Based on the NEOLAP trial results, Volker Kunzmann concluded that FOLFIRINOX did not show significant superiority over gemcitabine plus nab-paclitaxel for conversion rate or OS. However, patients achieving R0/R1 resection after chemotherapy showed markedly improved OS, suggesting induction chemotherapy may be beneficial for appropriate patients.

Source: Secondary Resectability Improved with Induction Chemotherapy in Locally Advanced Pancreatic Cancer [ESMO 2019 Oncology News]

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