734 Background: Gemcitabine/nab-paclitaxel (GnP), a standard first-line treatment option for advanced pancreatic cancer (aPC) patients (pts) based on the phase 3 MPACT trial, is typically administered days (d)1-8-15 every (Q) 28d. A modified schedule of d1-15 Q28d may be better tolerated with no deleterious impact on overall survival (OS) based on a small, single-arm, single-center retrospective study. We aimed to evaluate three GnP dosing schedules: d1-8-15 Q28, d1-15 Q28 and d1-8 Q21 in pts treated for at least 4 months (mo) without progression in the Michigan Medicine Optimal Treatment Schedule (MI-OPTS-2) study. Methods: This IRB approved retrospective study included consecutive pts 18 years or older who received first-line (1L) GnP for aPC between 01/2014-12/2024 with all available data. Pt characteristics, chemotherapy and related toxicity, and survival data were obtained through electronic medical records review at predefined intervals of 4 mo and end of chemotherapy. Survival probabilities were estimated using the product-limit method of Kaplan-Meier using SAS (v9.4, Cary, NC). Results: In 94 pts who met criteria, median (range) age was 68 (44-83) years, 54 (57.45%) were male, 81 (86.17%) were White, and 47 (50%) had ECOG performance status 1. Baseline characteristics, including age, sex, ECOG, albumin and BMI, were similar across the 3 treatment cohorts. Median (95% CI) progression-free survival was comparable across cohorts: 9.2 mo (7.1—9.2) for d1-8-15 Q28 (n=53), 8.3 mo (6.7-9.3) for d1-8 Q21 (n=19), and 8.2 mo (7.6-8.7) for d1-15 Q28 (n=22). Median (95% CI) OS showed no significant difference: 16.5 mo (11.8-21.6) for d1-8-15 Q28, 13.0 mo (9.5-16.3) for d1-8 Q21, and 19.8 mo (10.3-27.7) for d1-15 Q28 schedule. Incidences of peripheral neuropathy, neutropenia, thrombocytopenia and ECOG decline were also similar at 4 mo and completion of 1L treatment. Grade 2 or higher anemia was notably higher for pts at end of chemotherapy in d1-8 Q21 schedule. Dose reduction, interruption, change in schedule and discontinuation rates assessment are pending and will be presented. Conclusions: Similar baseline characteristics across cohorts suggest group practice differences rather than use of modified schedules in elderly or unfit pts. Modified regimens of GnP are associated with acceptable toxicity profile, lower cost and appear to be similarly effective to standard regimen in aPC.
Carvalho et al. (Sat,) studied this question.