Help
Subscribe


Submit Videos to GastroHep Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine

This week's issue of the New England Journal of Medicine examines the efficacy and safety of the combination versus gemcitabine monotherapy in patients with metastatic pancreatic cancer.

News image

In a phase 1–2 trial of albumin-bound paclitaxel (nab-paclitaxel) plus gemcitabine, substantial clinical activity was noted in patients with advanced pancreatic cancer.

Dr Daniel Von Hoff and colleagues conducted a phase 3 study of the efficacy and safety of the combination versus gemcitabine monotherapy in patients with metastatic pancreatic cancer.

The researchers randomly assigned patients with a Karnofsky performance-status score of 70 or more to nab-paclitaxel followed by gemcitabine on days 1, 8, and 15 every 4 weeks or gemcitabine monotherapy weekly for 7 of 8 weeks, and then on days 1, 8, and 15 every 4 weeks.

Patients received the study treatment until disease progression.

The researchers' primary end point was overall survival.

Febrile neutropenia occurred in 3% versus 1% of the patients in the 2 groups
New England Journal of Medicine

Secondary end points were progression-free survival and overall response rate.

A total of 861 patients were randomly assigned to nab-paclitaxel plus gemcitabine or gemcitabine.

The research team's median overall survival was almost 9 months in the nab-paclitaxel–gemcitabine group as compared with 7 months in the gemcitabine group.

The team found that survival rate was 35% in the nab-paclitaxel–gemcitabine group versus 22% in the gemcitabine group at 1 year, and 9% versus 4% at 2 years.

The researchers observed that median progression-free survival was 6 months in the nab-paclitaxel–gemcitabine group, as compared with 4 months in the gemcitabine group.

The response rate according to independent review was 23% versus 7% in the 2 groups.

The most common adverse events of grade 3 or higher were neutropenia, fatigue, and neuropathy.

The team found that febrile neutropenia occurred in 3% versus 1% of the patients in the 2 groups.

In the nab-paclitaxel–gemcitabine group, neuropathy of grade 3 or higher improved to grade 1 or lower in a median of 29 days.

Dr Von Hoff's team concludes, "In patients with metastatic pancreatic adenocarcinoma, nab-paclitaxel plus gemcitabine significantly improved overall survival, progression-free survival, and response rate, but rates of peripheral neuropathy and myelosuppression were increased."

NEJM 2013; 369: 1691-1703
05 November 2013

Go to top of page Email this page Email this page to a colleague

 29 May 2015

Advanced search
 29 May 2015 
Comfort during colonoscopy
 29 May 2015 
Colorectal neoplasia in liver transplant candidates
 29 May 2015 
Cervical cancer with immunosuppressive therapy in IBD
 28 May 2015 
Excercise and IBD
 28 May 2015 
Probiotics and Crohn's disease
 28 May 2015 
Bleeding and colorectal endoscopic submucosal dissection
 27 May 2015 
Vegetables and fruit and IBD
 27 May 2015 
Radiofrequency ablation for treatment of GERD
 27 May 2015 
Management of constipation and IBS
 26 May 2015 
Antimicrobials for intraabdominal infection
 26 May 2015 
Calcium channel blockers and GI bleeds
 26 May 2015 

Risk factors for celiac disease

 25 May 2015 
Colorectal cancer screening
 25 May 2015 
Saccharomyces boulardii and H. pylori
 25 May 2015 
Risk of GI bleeds with NSAIDs
 22 May 2015 
Colonoscopy screening for colorectal cancer
 22 May 2015 
Treatment with anti-integrin antibodies in IBD
 22 May 2015 
Care of patients with GERD
 21 May 2015 
Lymphoma in IBD
 21 May 2015 
Serrated polyps and colorectal cancer
 21 May 2015 
Imaging for hepatocellular carcinoma
 20 May 2015 
Pancreatic neuroendocrine tumors
 20 May 2015 
Surveillance in long-segment Barrett's
 20 May 2015 
Refractory metastatic colorectal cancer
 19 May 2015 
Metabolic syndrome and Barrett's
 19 May 2015 
PPIs and cryptogenic liver abscess
 19 May 2015 
Anti-integrin antibodies in IBD
 18 May 2015 
ESPGHAN celiac guidelines
 18 May 2015 
HLA haplotypes and primary sclerosing cholangitis
 18 May 2015 
Safety of PPI
 15 May 2015 
Microscopic colitis risk with PPIs/NSAIDs
 15 May 2015 
Management of nonhospitalized ulcerative colitis
 15 May 2015 
Diabetes and infections in IBD with immunomodulation
 14 May 2015 
Diagnosis of spontaneous bacterial peritonitis
 14 May 2015 
Mortality in US patients with cirrhosis
 14 May 2015 
Radiation exposure during ERCP
 13 May 2015 
Predictors of IBD
 13 May 2015 
Psychological distress and liver disease mortality
 13 May 2015 
Hypnotherapy in IBS/IBD
 12 May 2015 
Bleeding in NSAID users with H.pylori
 12 May 2015 
Capsule colonoscopy detects colorectal polyps
 12 May 2015 
Anti-TNF biologics in acute severe ulcerative colitis
 11 May 2015 
Management of Barrett's esophagus
 11 May 2015 
Marker to detect recurrence of Crohn's
 11 May 2015 
Thalidomide for IBD
 08 May 2015 
Surveillance colonoscopy in colorectal cancer
 08 May 2015 
HCV treatment with compensated cirrhosis
 08 May 2015 
Medical management of Crohn's
 07 May 2015 
Surgical complications in ulcerative colitis
 07 May 2015 
Combination therapy for noncirrhostic patients
 07 May 2015 
Anxiety and new-onset dyspepsia
 06 May 2015 
PPIs and spontaneous bacterial peritonitis
 06 May 2015 
Infant feeding and celiac disease
 06 May 2015 
Preventing recurrent C. diff infection
 05 May 2015 
Fatigue in primary sclerosing cholangitis
 05 May 2015 
Annual CT scans after esophagectomy for cancer
 05 May 2015 
Prevalence of eosinophilic esophagitis
 04 May 2015 
Stress resilience and peptic ulcer disease
 04 May 2015 
Endoscope storage and microbial colonization
 04 May 2015 
Menarche and NAFLD

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2015 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us