000076952 001__ 76952
000076952 005__ 20200117221619.0
000076952 0247_ $$2doi$$a10.1186/s12885-018-5101-3
000076952 0248_ $$2sideral$$a109775
000076952 037__ $$aART-2018-109775
000076952 041__ $$aeng
000076952 100__ $$aFernández, A.
000076952 245__ $$aPrognostic factors for survival with nab-paclitaxel plus gemcitabine in metastatic pancreatic cancer in real-life practice: The ANICE-PaC study
000076952 260__ $$c2018
000076952 5060_ $$aAccess copy available to the general public$$fUnrestricted
000076952 5203_ $$aBackground: Treatment with nab-paclitaxel plus gemcitabine increases survival in patients with metastatic pancreatic cancer. However, the assessment of treatment efficacy and safety in non-selected patients in a real-life setting may provide useful information to support decision-making processes in routine practice.
Methods: Retrospective, multicenter study including patients with metastatic pancreatic cancer, who started first-line treatment with nab-paclitaxel plus gemcitabine between December 2013 and June 2015 according to routine clinical practice. In addition to describing the treatment pattern, overall survival (OS) and progression-free survival (PFS) were assessed for the total sample and the exploratory subgroups based on the treatment and patients' clinical characteristics.
Results: All 210 eligible patients had a median age of 65.0 years (range 37-81). Metastatic pancreatic adenocarcinoma was recurrent in 46 (21.9%) patients and de novo in 164 (78.1%); 38 (18%) patients had a biliary stent. At baseline, 33 (18.1%) patients had an ECOG performance status =2. Patients received a median of four cycles of treatment (range 1-21), with a median duration of 3.5 months; 137 (65.2%) patients had a dose reduction of nab-paclitaxel and/or gemcitabine during treatment, and 33 (17.2%) discontinued treatment due to toxicity. Relative dose intensity (RDI) for nab-paclitaxel, gemcitabine, and the combined treatment was 66.7%. Median OS was 7.2 months (95% CI 6.0-8.5), and median PFS was 5.0 months (95% CI 4.3-5.9); 50 patients achieved either a partial or complete response (ORR 24.6%). OS was influenced by baseline ECOG PS, NLR and CA 19.9, but not by age = 70 years and/or the presence of hepatobiliary stent or RDI < 85%. All included variables, computed as dichotomous, showed a significant contribution to the Cox regression model to build a nomogram for predicting survival in these patients: baseline ECOG 0-1 vs. 2-3 (p = 0.030), baseline NLR > 3 vs. = 3 (p = 0.043), and baseline CA 19.9 > 37 U/mL vs. =37 U/mL (p = 0.004).
Conclusions: Nab-Paclitaxel plus gemcitabine remain effective in a real-life setting, despite the high burden of dose reductions and poorer performance of these patients. A nomogram to predict survival using baseline ECOG performance status, NLR and CA 19.9 is proposed.
000076952 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000076952 590__ $$a2.933$$b2018
000076952 591__ $$aONCOLOGY$$b121 / 229 = 0.528$$c2018$$dQ3$$eT2
000076952 592__ $$a1.336$$b2018
000076952 593__ $$aCancer Research$$c2018$$dQ1
000076952 593__ $$aOncology$$c2018$$dQ1
000076952 593__ $$aGenetics$$c2018$$dQ1
000076952 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000076952 700__ $$aSalgado, M.
000076952 700__ $$aGarcía, A.
000076952 700__ $$aBuxò, E.
000076952 700__ $$aVera, R.
000076952 700__ $$aAdeva, J.
000076952 700__ $$aJiménez-Fonseca, P.
000076952 700__ $$aQuintero, G.
000076952 700__ $$aLlorca, C.
000076952 700__ $$aCañabate, M.
000076952 700__ $$aLópez, L.J.
000076952 700__ $$aMuñoz, A.
000076952 700__ $$aRamírez, P.
000076952 700__ $$aGonzález, P.
000076952 700__ $$aLópez, C.
000076952 700__ $$aReboredo, M.
000076952 700__ $$aGallardo, E.
000076952 700__ $$aSanchez-Cánovas, M.
000076952 700__ $$aGallego, J.
000076952 700__ $$aGuillén, C.
000076952 700__ $$aRuiz-Miravet, N.
000076952 700__ $$aNavarro-Pérez, V.
000076952 700__ $$aDe La Cámara, J.
000076952 700__ $$aAlés-Díaz, I.
000076952 700__ $$0(orcid)0000-0002-8026-7391$$aPazo-Cid, R.A.$$uUniversidad de Zaragoza
000076952 700__ $$aCarmona-Bayonas, A.
000076952 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000076952 773__ $$g18, 1 (2018), 1185 [11 pp]$$pBMC CANCER$$tBMC CANCER$$x1471-2407
000076952 8564_ $$s654327$$uhttps://zaguan.unizar.es/record/76952/files/texto_completo.pdf$$yVersión publicada
000076952 8564_ $$s89997$$uhttps://zaguan.unizar.es/record/76952/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000076952 909CO $$ooai:zaguan.unizar.es:76952$$particulos$$pdriver
000076952 951__ $$a2020-01-17-21:52:28
000076952 980__ $$aARTICLE