New Option for the Initial Management of Metastatic Pancreatic Cancer?

the results of a randomized clinical trial conducted in patients with metastatic pancreatic cancer that compared gemcitabine with a combination of gemcitabine and nab-paclitaxel. In this trial, 861 patients were randomly assigned: 431 to gemcitabine plus nab-paclitaxel and 430 to gemcitabine alone. The high-level results demonstrated a median overall survival of 8.5 months in the nab-paclitaxel group comparedwith6.7monthsinthegemcitabinegroup.Thehazardratiofor death was 0.72 (95% CI, 0.62 to 0.83; P .001). Other end points, including progression-free survival and response rate, were superior withthecombination.Grade3neutropeniaoccurredin38%ofthe patientstreatedwithgemcitabineplusnab-paclitaxel,with3%ofthese instances resulting in febrile neutropenia. Twenty-six percent of the patients received growth factors. Cumulative peripheral neuropathy occurredin17%ofthepatientstreatedwithnab-paclitaxel,anditwas managed with temporary discontinuation of nab-paclitaxel followed by a reduction in dose. Overall, however, 71% of the nab-paclitaxel doses were delivered at the intended starting dose. 1