Second-line Modified GTX versus Gemcitabine-Nab-Paclitaxel (GmAb) Following First-Line FOLFIRINOX in Advanced Pancreatic Cancer: A Retrospective Analysis at the American University of Beirut Medical Center (AUBMC)

Temraz, Sally; Kreidieh, Firas; Nassar, Farah; Mezher, Maria; Mukherji, Deborah; Shamseddine, Ali

doi:10.30476/mejc.2023.95050.1770

Second-line Modified GTX versus Gemcitabine-Nab-Paclitaxel (GmAb) Following First-Line FOLFIRINOX in Advanced Pancreatic Cancer: A Retrospective Analysis at the American University of Beirut Medical Center (AUBMC)

Document Type : Original Article(s)

Authors

Sally Temraz

Firas Kreidieh

Farah Nassar

Maria Mezher

Deborah Mukherji

Ali Shamseddine

Department of Internal Medicine, Hematology/Oncology Division, American University of Beirut Medical Center, Beirut, Lebanon

https://doi.org/10.30476/mejc.2023.95050.1770

Abstract

Background: Pancreatic cancer is characterized by its generally poor prognosis and ranks seventh worldwide in cancer-related mortality. We previously conducted a prospective study on the use of modified GTX regimen (a combination of gemcitabine, docetaxel, and capecitabine), which has appreciable activity and is well-tolerated, in this setting. We compared the efficacy of GTX regimen versus Gemcitabine-nabpaclitaxel (GmAb) as second-line chemotherapy in advanced pancreatic cancer patients receiving first-line therapy with FOLFIRINOX.
Method: This retrospective chart review aimed to collect and record data corresponding to patients diagnosed with advanced pancreatic cancer at the American University of Beirut Medical Center who received FOLFIRINOX as first-line chemotherapy and who then had GTX or GmAb as second-line treatment between 2013 and 2019. We measured the progression-free survival, overall survival, and toxicity of GTX versus GmAb as second-line treatment for pancreatic adenocarcinoma at AUBMC.
Results: The median overall survival for the GmAb group was around 52 months, which is greater than that of the GTX group, which was 25 months. 26.7% of patients who received GTX required dose reduction starting from cycle one, while only 3.1% of those who received GmAb required dose reduction from cycle one. 38.7% of patients who received GmAb did not have anemia throughout the course of treatment, while the majority of patients who received GTX, 93.3%, had grade I anemia.
Conclusion: Our data show that GmAb is a possibly better second-line treatment option than GTX with better tolerance to the dose, less anemia, and a better survival profile. More studies are needed with a larger sample size and a prospective design to prove such a possible difference between the two regimens.

Highlights

Sally Temraz (Google Scholar)

Ali Shamseddine (Google Scholar)

Keywords

Gemcitabine

FOLFIRINOX

Pancreatic neoplasms

Second-line chemotherapy

How to cite this article:

Temraz S, Kreidieh F, Nassar F, Mezher M, Mukherji D, Shamseddine A. Second-line modified GTX versus Gemcitabine-Nab-Paclitaxel (GmAb) following first-line FOLFIRINOX in advanced pancreatic cancer: a retrospective analysis at the American University of Beirut Medical Center (AUBMC). Middle East J Cancer. 2023;14(4):550-8. doi: 10.30476/mejc.2023.95050.1770.

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