(Pancreatic Cancer) Is Abraxane + Gemzar Effective?
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This article is a summary of international medical information and is not medical advice; it cannot replace the diagnosis or treatment plan of your attending physician. The medical technologies, drug information and clinical data presented here are compiled from public literature and official statements of major Japanese medical institutions; the applicability and outcome of any therapy vary with each patient and must be assessed individually by a qualified physician.
On January 14, 2020, Philip A. Philip published in the medical journal The Lancet Gastroenterology & Hepatology the "Efficacy and Safety Results of Nab-paclitaxel (Abraxane) + Gemcitabine (Gemzar) in Patients with Unresectable Locally Advanced Pancreatic Cancer, from the LAPACT Phase 2 Clinical Trial."
The LAPACT Phase 2 clinical trial was a multicenter, open-label clinical trial. Patients with unresectable locally advanced pancreatic cancer (N=106) received induction therapy in 28-day cycles, with Abraxane 125 mg/m² + Gemzar 1000 mg/m² on days 1, 8, and 15. As long as there was no disease progression or unexpected adverse events, the attending physician determined whether to continue treatment (Abraxane + Gemzar, chemoradiotherapy, or surgery). The primary endpoint was time to treatment failure, and secondary endpoints were disease control rate, progression-free survival, and overall survival.
Of the 107 patients who received induction therapy, 44 (41%) discontinued due to adverse events and could not advance to the continuation phase. Of the 62 patients who completed induction therapy, 47 (44%) continued treatment: 12 with Abraxane + Gemzar, 18 with chemoradiotherapy, and 17 with surgery.
The trial results showed a primary endpoint median time to treatment failure of 9.0 months. Secondary endpoint results were: median progression-free survival of 10.9 months, median overall survival of 18.8 months, disease control rate of 77.6%, and objective response rate of 33.6%.
In terms of safety, the most common Grade 3 or higher adverse events observed in the majority of patients were: neutropenia 33%, anemia 11%, and fatigue 10%. More serious adverse events included: pneumonia 5%, fever 5%, and febrile neutropenia 3%.
Based on the LAPACT clinical trial results, Philip A. Philip concluded: "In patients with unresectable locally advanced pancreatic cancer, Abraxane + Gemzar demonstrated good antitumor activity. The adverse event profile was consistent with that documented in other clinical trials, with no new adverse events occurring."
Source: Nab-paclitaxel plus gemcitabine in patients with locally advanced pancreatic cancer (LAPACT): a multicentre, open-label phase 2 study (Lancet Gastroenterol Hepatol. 2020 Jan 14. DOI: https://doi.org/10.1016/S2468-1253(19)30327-9)
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