Long-term progression-free survival in a metastatic pancreatic cancer patient treated with first-line nab-paclitaxel and gemcitabine.

BACKGROUND: Prognosis of patients with metastatic pancreatic cancer is dismal. Recently, two first-line combination chemotherapy regimens have shown a survival benefit over single-agent gemcitabine.

PATIENTS AND METHODS: A 57-year old metastatic pancreatic cancer patient from our department (Eastern Cooperative Oncology Group performance status (ECOG PS): 0, baseline carbohydrate antigen (CA) 19-9 level: 2,900 U/ml) received 12 cycles of first-line chemotherapy with nab-paclitaxel and gemcitabine until disease progression within the pivotal Metastatic Pancreatic Adenocarcinoma Clinical Trial (MPACT).

RESULTS: Treatment with nab-paclitaxel and gemcitabine resulted in a partial response by Response Evaluation Criteria in Solid Tumors (RECIST), a rapid biochemical CA 19-9 response, a progression-free survival of 13 months and an overall survival of 20 months. Leukopenia grade 3 prompted dose reduction by two dose levels. Non-hematological toxicities included alopecia, skin rash, nail changes and peripheral neuropathy (all grade 2 or less).

CONCLUSION: First-line combination chemotherapy with nab-paclitaxel and gemcitabine is an effective and manageable treatment option for patients with metastatic pancreatic cancer with the potential for long-term disease control.