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Introduction: The goal of this non-randomized, retrospective, and observational study was to assess the efficacy of three different first-line chemotherapy regimens in the treatment of metastatic pancreatic cancer. Methods: Data were retrieved on 139 patients (pts) who were treated for metastatic pancreatic cancer in the University Hospital Centre Zagreb between January 1st, 2015 and March 1st, 2018. Pts were treated with nab-paclitaxel plus gemcitabine (Nab-Gem), gemcitabine plus cisplatin (Cis-Gem), or gemcitabine alone (Gem). Median age at the time of the beginning of therapy was 62 yrs in the Nab-Gem group (n ¼ 45), 64.4 yrs in the Cis-Gem group (n ¼ 19), and 70 yrs in the Gem group (n ¼ 75). Results: The median duration of treatment for Nab-Gem, Cis-Gem, and Gem regimens was 23.1, 24.7, and 12.9 weeks (w), respectively. Multivariate analyses tested influence of prognostic factors on treatment duration. In accordance with previous studies, for the pts treated with Nab-Gem the duration of treatment was negatively correlated with age (p < 0.05). The same age-dependent relationship was not observed in the Cis-Gem and Gem groups. Pts treated with Nab-Gem showed significant difference in terms of time to failure of treatment when analyzed for the two age groups separately, <65 and >65 yrs of age. The <65 group received chemotherapy for the median duration of 57.1 w compared to the >65 group which was treated with Nab-Gem for median of 21.5 w. No significant sex-dependent difference was found in regard to duration of treatment in any of the three treatment regimen groups. Conclusion: With regards to the above limitations of the study, we conclude that, for pts younger than 65 y, Nab-Gem is an effective chemotherapy regimen with significant clinical effect. Furthermore, for selected patients, a combined use of Cis-Gem is superior to Gem alone in the first-line treatment for metastatic pancreatic cancer.

Background: Although phase III studies have investigated the effect of adding bevacizumab to the 3-weekly capecitabine plus irinotecan (XELIRI) combination in the first-line treatment of metastatic colorectal cancer (mCRC), no phase III studies investigating the effects of adding bevacizumab to biweekly XELIRI have been published. Patients and Methods: A retrospective pooled analysis of 2 single-arm phase II studies was performed. Previously untreated patients with mCRC received irinotecan 175 mg/m² on day 1 followed by capecitabine 1,000 mg/m² twice daily on days 2-8 every 2 weeks with or without bevacizumab 5 mg/kg on day 1. Results: In total, 53 patients received XELIRI, and 46 patients received XELIRI plus bevacizumab. There was a statistically significant increase in partial response rate with XELIRI plus bevacizumab (63 vs. 26% for XELIRI; p = 0.0002) and overall response rate (67 vs. 32%; p = 0.0005). Median time to disease progression was significantly longer with XELIRI plus bevacizumab (12.3 vs. 9.0 months for XELIRI; p = 0.012); median overall survival did not differ significantly between treatments (23.7 vs. 19.3 months; p = 0.4997). The proportion of patients experiencing at least 1 grade 3/4 adverse event was similar with both treatments (XELIRI, 47%; XELIRI plus bevacizumab, 44%). Conclusion: This retrospective pooled analysis suggests that XELIRI plus bevacizumab has an acceptable tolerability profile and improves efficacy outcomes compared with XELIRI in the first-line treatment of mCRC.

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