Nab-paclitaxel plus gemcitabine seems to be effective, with a manageable toxicity profile, after FOLFIRINOX (fluorouracil, leucovorin, irinotecan, oxaliplatin) failure in patients with metastatic pancreatic adenocarcinoma, a new study published online ahead of print in the British Journal of Cancer has shown.1

Because there is currently no standard second-line treatment for metastatic adenocarcinoma, and progression-free survival is often less than 4 months in this setting, researchers sought to evaluate the efficacy and tolerability of nab-paclitaxel plus gemcitabine after FOLFIRINOX failure.

Researchers enrolled 57 patients with histologically proven metastatic pancreatic adenocarcinoma after failure of FOLFIRINOX treatment.

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All received nab-paclitaxel plus gemcitabine until disease progression, patient refusal, or unacceptable toxicity. Patients received treatment for a median of 4 cycles.

Results showed that the disease control rate 58%, with an objective response rate of 17.5%. Researchers found that the median overall survival was 8.8 months (95% CI: 6.2-9.7) and median progression-free survival was 5.1 months (95% CI: 3.2-6.2).

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The study demonstrated a median overall survival since the initiation of first-line chemotherapy of 18 months (95% CI: 16-21).

In regard to safety, grade 3 to 4 toxicities were reported in 40% of patients. The most common grade 3 to 4 adverse events were neutropenia, neurotoxicity, asthenia, and thrombocytopenia.


  1. Portal A, Pernot S, Tougeron D, et al. Nab-paclitaxel plus gemcitabine for metastatic pancreatic adenocarcinoma after Folfirinox failure: an AGEO prospective multicentre cohort. [published online ahead of print September 15, 2015]. B J Cancer. doi: 10.1038/bjc.2015.328.