Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 6, 2020; 8(13): 2778-2786
Published online Jul 6, 2020. doi: 10.12998/wjcc.v8.i13.2778
Adjuvant nab-paclitaxel plus gemcitabine vs gemcitabine alone for resected pancreatic ductal adenocarcinoma: A single center experience in China
Zhu-Zeng Yin, Zhi-Ming Zhao, Wen-Bo Tang, Nan Jiang, Ke-Di Zhang, Yu-Yao Song, Yang Wang, Cheng-Gang Li, Yuan-Xing Gao, Rong Liu
Zhu-Zeng Yin, Zhi-Ming Zhao, Wen-Bo Tang, Nan Jiang, Ke-Di Zhang, Yu-Yao Song, Yang Wang, Cheng-Gang Li, Yuan-Xing Gao, Rong Liu, The Second Department of Hepatopancreatobiliary Surgery, The First Medical Center, Chinese People’s Liberation Army General Hospital, Beijing 100853, China
Author contributions: Yin ZZ and Zhao ZZ contribute equally to this work; Yin ZZ and Zhao ZZ analyzed and interpreted the data and wrote the article; Tang WB, Jiang N, Zhang KD, Song YY, Wang Y, Li CG and Gao YX drafted the article and collected the data; Liu R designed the study.
Supported by the China Postdoctoral Science Foundation, No. 2015M582853.
Institutional review board statement: The study was approved by the Institutional Review Board of the Chinese People's Liberation Army General Hospital (S2016-098-02).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent. For full disclosure, the details of the study are published on the home page of Fukushima Medical University.
Conflict-of-interest statement: The authors declare that there is no conflict of interest related to this study.
Data sharing statement: Due to the sensitive nature of the questions asked in this study, survey respondents were assured raw data would remain confidential and would not be shared.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Rong Liu, MD, PhD, Professor, The Second Department of Hepatopancreatobiliary Surgery, The First Medical Center, Chinese People’s Liberation Army General Hospital, No. 28, Fuxing Road, Beijing 100853, China. liurong301@126.com
Received: March 15, 2020
Peer-review started: March 15, 2020
First decision: April 22, 2020
Revised: May 2, 2020
Accepted: June 7, 2020
Article in press: June 7, 2020
Published online: July 6, 2020
Abstract
BACKGROUND

Nab-paclitaxel plus gemcitabine (AG) has resulted in higher tumor response and survival rates for metastatic or advanced pancreatic ductal adenocarcinoma (PDAC) compared with gemcitabine (GEM) alone.

AIM

To examine the feasibility and safety of AG adjuvant chemotherapy of resectable PDAC.

METHODS

We retrospectively analyzed patients with resected PDAC who received AG or GEM as postoperative adjuvant treatment between January 2013 and December 2016 at the Chinese People’s Liberation Army General Hospital, Beijing, China. The patients adopted combined nab-paclitaxel (125 mg/m2) and GEM (1 g/m2) or GEM (1 g/m2) alone treatment, on days 1 and 8 every 3 wk for six cycles, unless intolerable adverse events or disease progression occurred. The disease-free survival, overall survival (OS) and adverse events of the two groups were statistically analyzed.

RESULTS

Compared with GEM, median disease-free survival (12.2 mo vs 15.8 mo, P = 0.039) and OS (20.6 mo vs 28.3 mo, P = 0.028) were significantly improved in the AG group. The 2-year OS rates were 63.3% and 43.3% in the AG and GEM groups, respectively. However, the incidence of sensory neuropathy was increased significantly in the AG than the GEM group (53.3% vs 23.3%, P < 0.001).

CONCLUSION

In our initial experience, AG significantly improved disease-free survival and OS of patients with resected PDAC. AG may be a potential option for postoperative adjuvant chemotherapy of resectable PDAC.

Keywords: Nab-paclitaxel, Gemcitabine, Pancreatic ductal adenocarcinoma, Surgery, Adjuvant, Resectable

Core tip: Nab-paclitaxel plus gemcitabine (AG) has resulted in better survival and tumor response rates for advanced or metastatic pancreatic ductal adenocarcinoma (PDAC) compared with gemcitabine alone. However, its role in adjuvant therapy for resected PDAC remains unclear. We retrospectively reviewed our PDAC database for patients with primary resectable PDAC who were treated with AG or gemcitabine alone as postoperative adjuvant chemotherapy between January 2013 and December 2016. Our results suggested that AG significantly improved disease-free survival and overall survival of patients with resected PDAC. AG may be a potential option for postoperative adjuvant chemotherapy of resectable PDAC.