<em>nab</em>-Paclitaxel for the treatment of pancreatic cancer

Abstract

BackgroundNanoparticle albumin-bound paclitaxel (nab-P) plus gemcitabine (Gem) became a standard treatment option for metastatic pancreatic cancer (MPC) following positive results from a global phase III trial (MPACT). A large number of studies have now published results on the use of nab-P/Gem to treat advanced and early-stage disease, warranting a comprehensive review. The main goal of this systematic review is to summarize the efficacy and safety data of nab-P/Gem for the treatment of pancreatic cancer (PC).MethodsThis systematic review includes results from studies that either published results in a peer-reviewed journal or presented the results at a major oncology conference.ResultsSixty-two studies were included (50 in the advanced/metastatic setting and 12 in the locally advanced setting). Most studies on the treatment of MPC were exclusively first line (33/50). Nevertheless, the studies in this review comprised a broad spectrum of patients, including those <65 and ≥65 years of age and those with a Karnofsky performance status of 70–100. Median overall survival (OS) in studies of nab-P/Gem in the advanced/metastatic setting ranged from 8.7 to 13.5 months. In addition, 15 studies of patients with advanced/metastatic PC examined nab-P/Gem as a backbone on which to add a variety of agents, including cancer stem cell inhibitors, stromal disrupting agents, and immune-modulating agents (median OS, 6.9–17 months). Ongoing trials are investigating nab-P/Gem with or without other agents across disease settings.DiscussionStudies conducted after MPACT have demonstrated that nab-P/Gem is an effective regimen for the first-line treatment of MPC for a wide range of patients. Regimens using nab-P/Gem as a backbone on which to combine additional agents are being studied actively, particularly in the advanced disease setting. Ongoing studies will yield valuable insights on the utility of nab-P–containing regimens to improve patient outcomes in PC in both earlier-stage and advanced disease.

Pharmacometabolomics Identifies 3-Hydroxyadipic Acid, d-Galactose, Lysophosphatidylcholine (P-16:0), and Tetradecenoyl-l-Carnitine as Potential Predictive Indicators of Gemcitabine Efficacy in Pancreatic Cancer Patients

“…However, GEM plus nab-PTX doublet therapy significantly inhibited tumor growth in both subgroups. These results were similar to clinical trial results (37,38).…”

Polymer Therapeutics: Biomarkers and New Approaches for Personalized Cancer Treatment

“…Interestingly, a study has described how a mutation to the KRAS gene in pancreatic cancer cells display elevated levels of macropinocytosis, a form of endocytosis, of proteins such as albumin [ 130 ], a fact which may be behind the recent success of Abraxane in treating advanced pancreatic cancer [ 131 ]. This raises the question as to if oncogenic mutations correlate to increased endocytosis of PTs and can be used as biomarkers for PT therapeutic response.…”

Comparison of Pancreatic Cancer Treatment Outcomes: A Real-World Data Analysis

“…The results of the study by De Vita et al (39) and a meta-analysis of 50 studies presented at an international conference suggest that with careful and appropriate patient selection, a median OS of longer than 12 months can be attained with 1L gem + nab-P (40).…”