Overall Survival, Metabolic Response Higher in Pancreatic Cancer Treated With Nab-paclitaxel Plus Gemcitabine

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 SUV_max values were 4.6 in the nab-paclitaxel plus gemcitabine group and 4.5 in the gemcitabine-alone group.

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).   

Reference

1. 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.