Nab-Paclitaxel Plus Gemcitabine in Locally Advanced Pancreatic Cancer: LAPACT Trial

On January 14, 2020, Dr. Philip A. Philip and colleagues published the results of the LAPACT Phase 2 clinical trial in The Lancet Gastroenterology & Hepatology. This multicenter, open-label study investigated the role of Nab-paclitaxel (Abraxane) combined with Gemcitabine (Gemzar) as an induction treatment for patients with unresectable locally advanced pancreatic cancer (LAPC).

Study Design: LAPACT Trial

The trial enrolled 106 patients who received Nab-paclitaxel (125 mg/m²) plus Gemcitabine (1,000 mg/m²) on days 1, 8, and 15 of a 28-day cycle for six cycles. Following induction, patients without disease progression or unacceptable toxicity could continue treatment at the investigator's discretion (with chemotherapy, chemoradiotherapy, or surgery).

The primary endpoint was time to treatment failure (TTF).

Key Efficacy Results

• Median Time to Treatment Failure (TTF): 9.0 months.
• Median Progression-Free Survival (PFS): 10.9 months.
• Median Overall Survival (OS): 18.8 months.
• Disease Control Rate (DCR): 77.6%.
• Objective Response Rate (ORR): 33.6%.

Notably, among the 62 patients who completed the induction phase, 17 patients (16% of the total cohort) were able to undergo surgical resection.

Safety Profile

The most common Grade 3 or higher adverse events included:

• Neutropenia: 33%
• Anemia: 11%
• Fatigue: 10%
• Serious events such as pneumonia (5%) and febrile neutropenia (3%) were also reported.

Conclusion

The LAPACT trial results demonstrate that the combination of Nab-paclitaxel and Gemcitabine provides significant antitumor activity and a manageable safety profile in patients with locally advanced pancreatic cancer. These findings support this regimen as a potent induction strategy that may enable subsequent definitive therapies, including surgery, for some patients.

Source: The Lancet Gastroenterology & Hepatology - LAPACT Results

#PancreaticCancer #NabPaclitaxel #Gemcitabine #Gemzar #LAPACTTrial #CancerResearch #LAPC

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