Gemcitabine Plus Nab-Paclitaxel With Hydroxychloroquine in Pancreatic Cancer

Clinical Trial Design and Patient Characteristics

• June 17, 2019
• Reading time: 2 minutes

On May 23, 2019, JAMA Oncology published Phase II clinical trial results evaluating the efficacy and safety of gemcitabine plus nab-paclitaxel with and without hydroxychloroquine in treatment-naive advanced pancreatic cancer patients. The trial enrolled 112 patients with treatment-naive advanced pancreatic cancer: 55 patients received gemcitabine plus nab-paclitaxel with hydroxychloroquine, and 57 patients received gemcitabine plus nab-paclitaxel without hydroxychloroquine. The primary endpoint was one-year overall survival (OS), with secondary endpoints including progression-free survival (PFS), overall survival duration, and objective response rate (ORR).

Trial Background and Patient Demographics

Mean Age: Hydroxychloroquine group: 64 years; Control group: 65 years

Gender Distribution: Hydroxychloroquine group: 38% female, 62% male; Control group: 40% female, 60% male

Baseline CA19-9 Levels: Hydroxychloroquine group: 2,046 U/mL; Control group: 1,375 U/mL

Tumor Location Distribution:

• Hydroxychloroquine group: pancreatic head 40%, body 36%, tail 24%
• Control group: pancreatic head 51%, body 26%, tail 23%

Clinical Trial Results

Primary Endpoint - One-Year Overall Survival:

• Hydroxychloroquine group: 41%
• Control group: 49%

Secondary Endpoints:

Progression-Free Survival:

• Hydroxychloroquine group: 5.7 months
• Control group: 6.4 months

Overall Survival Duration:

• Hydroxychloroquine group: 11.1 months
• Control group: 12.1 months

Objective Response Rate:

• Hydroxychloroquine group: 38.2%
• Control group: 21.1%

Adverse Events

Both treatment groups experienced similar toxicity profiles, including neutropenia, anemia, fatigue, and peripheral neuropathy. Notable finding: the hydroxychloroquine combination group demonstrated significantly improved objective response rates (38.2% vs. 21.1%), despite comparable one-year overall survival outcomes between groups. The improved tumor response rates with hydroxychloroquine addition warrant further clinical investigation for their potential impact on disease control and subsequent therapeutic interventions.

Data Source

Effect of Gemcitabine and Nab-Paclitaxel With or Without Hydroxychloroquine on Patients With Advanced Pancreatic Cancer: A Phase 2 Randomized Clinical Trial. JAMA Oncol. 2019 May 23. doi: 10.1001/jamaoncol.2019.0684.

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