(040) Comparing the Efficacy and Safety of Gemcitabine + Abraxane (G+A) Versus Gemcitabine + Abraxane + Capecitabine (GAX) in the Treatment of Locally Advanced or Metastatic Pancreatic Cancer

Poster Abstract: B ackground: Pancreatic cancer is a highly aggressive malignancy with a poor prognosis. [1,2] Gemcitabine + Abraxane (G+A) is a commonly used first-and second line chemotherapy regimen in patients with locally advanced and metastatic pancreatic cancer, with the MPACT trial showing a statistically significant improvement in overall survival compared to gemcitabine monotherapy. [3] Capecitabine is occasionally added to the regimen of gemcitabine + Abraxane + capecitabine (GAX)) in the first line setting . Limited data has been published on the use of the GAX regimen, mostly focusing on tolerability of the regimen rather than efficacy. [4] The addition of capecitabine may offer increased efficacy, but also may add increased toxicity.

Purpose: This study aims to compare the efficacy and safety of G+A versus GAX in patients with locally advanced or metastatic pancreatic cancer.

Methods: This is a single-center, retrospective cohort study. Patients diagnosed with locally advanced or metastatic pancreatic cancer who received either G+A or GAX from January 2014 – September 2023 will be included in the study. Included patients will have locally advanced or metastatic pancreatic ductal adenocarcinoma receiving G+A with or without capecitabine. Patients will be excluded if receiving their treatment as neoadjuvant or adjuvant therapy, are being treated for a neuroendocrine tumor, or if their care was not reflected in the available medical charts. Baseline characteristics, treatment regimens, and outcomes will be collected from electronic medical records. Collected baseline characteristics will include; genetic mutations, location of primary tumor and sites of metastasis, number of metastatic sites, kidney and liver function, ECOG performance status, CA19-9 level at diagnosis. The primary endpoint is progression-free survival (PFS). Secondary endpoints include overall survival (OS), objective response rate (ORR), and all-grade and grade 3-4 toxicity.
The primary objective of this study is to compare the progression free survival of patients receiving G+A versus patients receiving GAX. Additional objectives will include determining the median overall survival of each regimen, objective response rates, the rate of previously selected toxicities, and evaluation of the relationship between patient/disease factors.

Conclusion: This study will provide valuable information on the efficacy and safety of GAX versus G+A in patients with locally advanced or metastatic pancreatic cancer.

References (must also be included in final poster): [1] Khalaf N, El-Serag HB, Abrams HR, Thrift AP. Burden of Pancreatic Cancer: From Epidemiology to Practice. Clin Gastroenterol Hepatol. 2021;19(5):876-884. doi:10.1016/j.cgh.2020.02.054
[2] McGuigan A, Kelly P, Turkington RC, Jones C, Coleman HG, McCain RS. Pancreatic cancer: A review of clinical diagnosis, epidemiology, treatment and outcomes. World J Gastroenterol. 2018;24(43):4846-4861. doi:10.3748/wjg.v24.i43.4846
[3] Von Hoff DD, Ervin T, Arena FP, et al. Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine. N Engl J Med. 2013;369(18):1691-1703. doi:10.1056/NEJMoa1304369
[4] Ko AH, Truong TG, Kantoff E, et al. A phase I trial of nab-paclitaxel, gemcitabine, and capecitabine for metastatic pancreatic cancer. Cancer Chemother Pharmacol. 2012;70(6):8