Abstract
Gemcitabine (GEM) plus albumin-bound paclitaxel (nab-paclitaxel, nab-PTX) combination chemotherapy, known as GN-therapy, has demonstrated efficient anti-tumor effect and statistically significant overall survival of patients with metastatic or locally advanced pancreatic ductal adenocarcinoma (PDAC) compared with GEM monotherapy. This regimen was approved in 2014 as a standard care treatment option for patients with PDAC in Japan. While severe neutropenia is a frequent adverse effect of GN-therapy, the frequency in 2nd-line use is still poorly understood. Thus, we retrospectively investigated clinical data to compare the frequency of adverse effects between 1st-line and 2nd-line use and the risk factor for sever neutropenia in PDAC patients treated with GN-therapy.
We analyzed 52 patients who received GN-therapy for advanced PDAC. The endpoint of the survey was the occurrence of neutropenia. Risk factors significantly related to severe neutropenia were identified using logistic regression analysis. Of the 52 patients studied, the mean age ± SD was 65.7 ± 9.4 years, and 32 (61.5％) were male. The frequency of severe neutropenia was not different in 1st-line (65.4％) and 2nd-line use (57.7％) (P = 0.776) and thus 2nd-line use of GN-therapy can be as safe and effective for PDAC as 1st-line use is. In the univariate and multivariate analysis, our data suggests that low level-absolute count of white blood cells (WBC), neutrophils (ANC) and alanine aminotransferase (ALT) are important predictive risk factors for severe neutropenia in patients with PDAC after the first course of GN-therapy and can make chemotherapy for PDAC more relevant and individualized.
