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In September 2013, the combination of nab-paclitaxel and gemcitabine was approved as a first-line treatment for patients with metastatic adenocarcinoma of the pancreas based on results from the phase III MPACT trial. This study showed that adding nab-paclitaxel to gemcitabine improved overall survival by nearly 2 months compared with gemcitabine alone (8.5 months versus 6.7 months), explains Ramesh K. Ramanathan, MD.
Due to differences in the clinical trial designs, it is difficult to compare the efficacy of the chemotherapy regimen FOLFIRINOX to the combination of nab-paclitaxel and gemcitabine, which makes selecting a first-line treatment difficult. Moreover, the panelists don’t believe a head-to-head trial comparing the two agents will ever happen.
At this point, E. Gabriela Chiorean, MD, notes that FOLFIRINOX appears to be more toxic. As a result, she prefers nab-paclitaxel plus gemcitabine as a first-line treatment for patients with metastatic pancreatic cancer.