Efficacy Analysis Of Gemcitabine Plus Albumin-bound Paclitaxel Combined With PD-1 Mab In Unresectable Pancreatic Cancer

Objective:To observe the efficacy and safety of gemcitabine plus albumin-bound paclitaxel in combination with PD-1 mab in patients with unresectable pancreatic cancer.Methods:The patients diagnosed with pancreatic cancer from January 2020 to June 2021 in the Department of Hepatobiliary Surgery of the Affiliated Hospital of Guizhou Medical University and Affiliated Cancer Hospital of Guizhou Medical University were screened.Based upon the inclusion and exclusion criteria,the patients treated with gemcitabine plus albumin-bound paclitaxel were divided as control group,while patients treated with gemcitabine plus albumin-bound paclitaxel combined with PD-1mab were divided as study group.By evaluating the progression free survival(PFS),overall survival(OS)and the occurrence of adverse reactions,the efficacy and safety of gemcitabine plus albumin-bound paclitaxel combined with PD-1 mab in unresectable pancreatic cancer was comprehensively evaluated.Results:The general data(gender,age,TNM staging,tumor location,jaundice,low back pain,smoking,alcohol drinking,previous pancreatitis,CA19-9,total bilirubin,alanine aminotransferase,aspartate aminotransferase,γ-glutamyl transferase,alkaline phosphatase,albumin and tumor maximum diameter)between the two groups were not statistically significant(P> 0.05).The results of rank sum test showed that the ORR and DCR rates of patients treated with gemcitabine plus albumin bound paclitaxel combined with PD-1 mab were higher,which was statistically significant compared with the control group(P <0.05).The common adverse reactions in this study were hematological toxicity and non-hematological toxicity,of which hematological toxicity included leukopenia,thrombocytopenia,and anemia;non-hematological toxicity included diarrhea,vomiting,peripheral neuropathy,hypothyroidism and reactive cutaneous capillary hyperplasia.There was no significant difference in the overall incidence of adverse reactions between the two groups(P> 0.05).Follow-up showed that 8 of the 23 patients in the study group died(34.78%),while median PFS and median OS are 6.66 months and 9.71 months,respectively;45 patients in the control group died 23(51.11%),while while median PFS and median OS are 4.93 months and 8.58 months,respectively.Kaplan-Meier survival analysis showed that the progression-free survival and total survival of study group were higher than controls(P <0.05).Results of the univariate analysis are showed that CA19-9>37U/m L and hepatic metastasis were the related influencing factors for the death of patients with unresectable pancreatic cancer(P<0.05).Conclusions:Gemcitabine plus albumin-bound paclitaxel in combination with PD-1 mab for patients with unresectable pancreatic cancer has a better outcome,while its adverse effects were not significantly different from gemcitabine plus albumin-combined paclitaxel chemotherapy.