open access

Vol 13, No 1 (2017)
Review paper
Published online: 2017-07-21
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Palliative systemic treatment of patients with pancreatic cancer — should reimbursement of nab-paclitaxel change the current management paradigm?

Rafał Czyżykowski, Anna Janiak, Magdalena Krakowska, Piotr Potemski
DOI: 10.5603/OCP.2017.0002
·
Oncol Clin Pract 2017;13(1):8-13.

open access

Vol 13, No 1 (2017)
REVIEW ARTICLES
Published online: 2017-07-21

Abstract

Pancreatic cancer is associated with poor prognosis. In the majority of patients the disease is diagnosed at an inoperable stage, so palliative chemotherapy is the only possible management. In a highly clinically and biochemically selected subpopulation two chemotherapy multi-drug schemes: FOLFIRINOX regimen and combination of nab-paclitaxel with gemcitabine, are more effective than gemcitabine alone, being the current standard of treatment. As there is a lack of direct comparison between doublet and triplet chemotherapies and the prognosis of patients enrolled to ACCORD 11 and MPACT clinical trials is similar, an attempt at indirect analysis was undertaken. It seems that chemotherapy with the use of FOLFIRINOX regimen prolongs overall survival significantly more and mainly has a beneficial impact on quality of life. In the authors’ opinion, the possibilities of using chemotherapy containing nab-paclitaxel and gemcitabine are quite limited. In patients with worse performance status monotherapy with gemcitabine or best supportive care should remain a standard of management.

Abstract

Pancreatic cancer is associated with poor prognosis. In the majority of patients the disease is diagnosed at an inoperable stage, so palliative chemotherapy is the only possible management. In a highly clinically and biochemically selected subpopulation two chemotherapy multi-drug schemes: FOLFIRINOX regimen and combination of nab-paclitaxel with gemcitabine, are more effective than gemcitabine alone, being the current standard of treatment. As there is a lack of direct comparison between doublet and triplet chemotherapies and the prognosis of patients enrolled to ACCORD 11 and MPACT clinical trials is similar, an attempt at indirect analysis was undertaken. It seems that chemotherapy with the use of FOLFIRINOX regimen prolongs overall survival significantly more and mainly has a beneficial impact on quality of life. In the authors’ opinion, the possibilities of using chemotherapy containing nab-paclitaxel and gemcitabine are quite limited. In patients with worse performance status monotherapy with gemcitabine or best supportive care should remain a standard of management.

Get Citation

Keywords

FOLFIRINOX, nab-paclitaxel, pancreatic cancer

About this article
Title

Palliative systemic treatment of patients with pancreatic cancer — should reimbursement of nab-paclitaxel change the current management paradigm?

Journal

Oncology in Clinical Practice

Issue

Vol 13, No 1 (2017)

Article type

Review paper

Pages

8-13

Published online

2017-07-21

DOI

10.5603/OCP.2017.0002

Bibliographic record

Oncol Clin Pract 2017;13(1):8-13.

Keywords

FOLFIRINOX
nab-paclitaxel
pancreatic cancer

Authors

Rafał Czyżykowski
Anna Janiak
Magdalena Krakowska
Piotr Potemski

References (9)
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