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Multicenter Study
. 2025 Apr 5;15(1):11675.
doi: 10.1038/s41598-025-96157-6.

Efficacy of gemcitabine plus nab-paclitaxel in second-line treatment of metastatic pancreatic cancer

Yasin Sezgin  1 , Oğur Karhan  2 , Mehmet Naci Aldemir  3 , Muslih Ürün  3 , Berrak Mermit Erçek  3 , Zuhat Urakcı  4 , Hayati Arvas  4 , Sezai Tunç  5 , Mehmet Erdem  6 , Halis Yerlikaya  7 , Serdar İleri  8 , İbrahim Aydın  9 , Abdurrahman Bicer  9 , Ahmet Ufuk Kömüroğlu  10 , Nargiz Majidova  11 , Savaş Gökçek  12 , Hacer Demir  13 , Sedat Yıldız  13 , Sinem Akbaş  14 , Esra Özen  15 , Burcu Ulaş Kahya  16 , Mürsel Sali  17 , Hicran Anık  18 , Talat Aykut  19 , Murat Araz  19 , Ali Alkan  20 , Melike Özçelik  21 , Abudllah Sakin  22 , Musa Barış Aykan  23 , Mirmehdi Mehtıyev  24 , Bilgin Demir  25 , Mehmet Nuri Başer  25 , Müge Sönmez  26 , İlkay Gültürk  3 , Nilüver Avcı  3 , Semiha Urvay  3 , Mustafa Özgür Arıcı  3 , Mehmet Emin Kalender  3 , Mustafa Yıldırım  3 , Ali Alper Solmaz  27 , Mustafa Gürbüz  27 , Yakup Ergün  28
Affiliations
Multicenter Study

Efficacy of gemcitabine plus nab-paclitaxel in second-line treatment of metastatic pancreatic cancer

Yasin Sezgin et al. Sci Rep. .

Abstract

Despite numerous studies on second-line therapies in metastatic pancreatic cancer, there is no randomized study evaluating the efficacy of gemcitabine plus nab-paclitaxel as a second-line treatment. This study aims to examine the efficacy of gemcitabine plus nab-paclitaxel in second-line therapy. In this retrospective study, a total of 218 patients from 23 centers were included. The primary endpoint was progression-free survival (PFS), secondary endpoints included overall survival (OS), treatment efficacy based on ECOG performance status (PS), and tumor marker (CEA, CA 19 - 9) levels. In the second-line treatment with gemcitabine plus nab-paclitaxel, the median PFS was 5.1 months (95% CI, 5.6 to 7.1), and the median OS was 8.6 months (95% CI, 7.3 to 10.0). Median PFS was 6.6 months in patients with normal CEA levels compared to 4.4 months in patients with high CEA levels (P = 0.01). Median PFS was 6 months in patients with ECOG PS 0-1 compared to 3.8 months in patients with PS 2 (P < 0.01). This study demonstrates the contribution of gemcitabine plus nab-paclitaxel in both OS and PFS in second-line treatment of metastatic pancreatic cancer. It was found to be a good option especially for young patients with good ECOG PS.

Keywords: Gemcitabine plus Nab-Paclitaxel; Metastatic pancreatic cancer; Overall survival; Progression-free survival.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Ethical approval and informed consent: The study protocol was approved by The Van Regional Training and Research Hospital (IRB No. 2023 / 19/ 04 -13.09.2023). Due to the retrospective nature of the study, the need for informed consent was waived with the decision of the Ethics Committee of Van Regional Training and Research Hospital. The study was performed in accordance with the ethical guidelines of the World Medical Association’s Declaration of Helsinki.

Figures

Fig. 1
Fig. 1
Flowchart of study population selection including patient recruitment and exclusion criteria.
Fig. 2
Fig. 2
Progression-free survival in patients with partial response and stable disease at 3 months of treatment.
Fig. 3
Fig. 3
Progression-free survival in patients with normal and elevated CEA levels.
Fig. 4
Fig. 4
Overall survival in patients with normal and elevated CEA levels.
Fig. 5
Fig. 5
Progression-free survival in patients with ECOG PS 0–1 and 2.
Fig. 6
Fig. 6
Overall survival in patients with ECOG PS 0–1 and 2.
See this image and copyright information in PMC

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