Dr. Ramanathan on Gemcitabine and Nab-Paclitaxel in Pancreatic Cancer

Ramesh K. Ramanathan, MD, medical director, Clinical Trials Program, Virginia G. Piper Cancer Center, describes a phase II study that analyzed gemcitabine and nab-paclitaxel followed by consolidation with mFOLFIRINOX in patients with metastatic pancreatic cancer.

This study, presented at the 2014 Gastrointestinal Cancers Symposium, set out to evaluate the feasibility of gemcitabine and nab-paclitaxel followed by FOLFIRINOX in this space. Thirty patients were treated with gemcitabine and nab-paclitaxel for up to 6 months. At the end of 6 months, or if progression occured earlier, patients went on to receive FOLFIRINOX.

About 50% of patients treated with gemcitabine and nab-paclitaxel were able to receive FOLFIRINOX while others received FOLFIRI or FOLFOX. Ramanathan says it was encouraging to see that 1-year survival was about 60% and median survival was about 14.5 months. Though this was just a small pilot phase II study, this sequence is worth pursuing, Ramanathan says, as well as the alternate sequence: FOLFIRINOX followed by gemcitabine and nab-paclitaxel.