Clinical Observation Of Albumin-bound Paclitaxel Plus Gemcitabine In Patients With Pancreatic Cancer

Objective:The purpose of the study was to evaluate the efficacy and safety of albumin-bound paclitaxel(Nab-p) plus gemcitabine(GEM) for the treatment of pancreatic cancer patients.Methods:Between February 2014 and January 2016,11 cases were treated with(Nab-p+GEM)in our institution. 5 patients were resectable and accepted radical resections followed by Nab-p+GEM while 6 patients, including 2 cases of locally advanced pancreatic cancer and 4 cases of metastatic pancreatic cancer(MPC),accepted chemo-based palliative threrapy.The primary end point was progression free survival.The second end point were overall survival, objective response rate, adverse effects.Results:The patients, including 6 males and 5 females,had an age rang from 38 to 69 years, with a median age of 51 years old.CA19-9>37 U / ml in 6 cases, 5 cases of normal.There are 6 cases of tumors located in the head, 5 cases in body and tail. According to 2010 WHO classification of tumors of the digestive system based on classification, 11 cases were pancreatic adenocarcinoma,including 4 cases of metastatic ductal adenocarcinoma,6 cases of differentiated ductal adenocarcinoma,1 cases of poorly differentiated adenocarcinoma.In the palliative chemotherapy group, of the 4 patients with MPC, 1 cases had partial response(PR), 1 cases had stable disease(SD) and 2 case progress during treatment. The objective response rate(ORR) was 25%, the disease control rate(DCR) was 50% and the median progression free survival(PFS) was 15 months. Of the 2 patients with LAPC,1 cases had partial response(PR) and 1 cases had stable disease(SD). The objective response rate(ORR) was 50%, the disease control rate(DCR) was 100% and the median progression free survival(PFS) was 6.5 months. 5 cases of postodperative adjuvant chemotherapy patients were followed up by the deadline, all of them showed obvious improvements of symptoms without toxicity related event and tumor recurrence. The most frequently reported hematologic adverse events related to treatment were hypoleucocytosis(in 54.5% of patients)and anemia(in 36.4%).The most frequently reported nonhematologic adverse events related to treatment were alopecia(in 72,7%), liver function damage(in 27.3%) and fatigue(in 45.5%).But the symptoms are mild. KPS score increased in 3 cases(27.3%), stable in 6 cases(54.5%), decreased in 2 cases(18.2%).Conclusion:Albumin-bound paclitaxel combined with gemcitabine chemotherapy can effectively prolong the progression free survival in patients with metastatic pancreatic cancer and locally advanced pancreatic cancer.Preliminary results of postoperative adjuvant chemotherapy in patients with R0 resection shows that the chemotherapy regimen can reduce local recurrence rate,with high safety and high patient tolerance. The combination of Nab-p and GEM is effective and tolerable in the treatment of pancreatic cancer patients.