Metabolic response rate was significantly higher in patients with metastatic pancreatic cancer treated with nab-paclitaxel and gemcitabine compared with those treated with gemcitabine alone.1
Investigators sought to examine the feasibility of positron emission tomography (PET) and to compare metabolic response rates and associated links to efficacy in the phase 3 MPACT trial.
Patients with untreated metastatic pancreatic cancer were randomly assigned 1:1 to receive either nab-paclitaxel plus gemcitabine or gemcitabine alone until disease progression or unacceptable toxicity.
A total of 257 patients received PET scans, of which 252 had 2 or more PET-avid lesions. Baseline median SUVmax values were 4.6 in the nab-paclitaxel plus gemcitabine group and 4.5 in the gemcitabine-alone group.
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Metabolic response by PET was linked to longer overall survival (11.3 vs 6.9 months; HR, 0.56; P < .001). Efficacy results were also linked to metabolic response. Patients who received nab-paclitaxel had a higher best response rate and week 8 response rate than those who received gemcitabine alone (best response: 72% vs 53%, P
= .002; week 8: 67% vs 51%; P = .014). Higher efficacy results in the PET cohort were also greater for the nab-paclitaxel group: overall survival median 10.5 vs 8.4 months; HR, 0.71; P = .009) and overall response rate by RECIST (31% vs 11%; P < .001).
- Ramanathan RK, Goldstein D, Korn RL et al. Positron emission tomography response evaluation from a randomized phase III trial of weekly nab-paclitaxel plus gemcitabine vs gemcitabine alone for patients with metastatic adenocarcinoma of the pancreas [published online ahead of print January 22, 2016]. Ann Oncol. doi: 10.1093/annonc/mdw020.