The combination of nab-paclitaxel and gemcitabine demonstrated greater efficacy than gemcitabine alone but resulted in higher rates of chemotherapy-induced peripheral neuropathy (CINP) in patients with metastatic pancreatic cancer (mPC). We aimed to evaluate the correlation between the development of treatment-related peripheral neuropathy and the efficacy of nab-P/Gem combination in these patients. mPC patients treated with nab-paclitaxel 125 mg/m(2) and gemcitabine 1000 mg/m(2) as a first-line therapy were included. Treatment-related adverse events, mainly peripheral neuropathy, were categorized using the National Cancer Institute Common Toxicity Criteria scale, version 4.02. Efficacy outcomes, including overall survival (OS), progression-free survival (PSF), and disease control rate (DCR), were estimated by the Kaplan-Meier model. A total of 153 patients were analyzed; of these, 47 patients (30.7%) developed grade 1-2 neuropathy. PFS was 7 months (95% CI (6-7 months)) for patients with grade 1-2 neuropathy and 6 months (95% CI (5-6 months)) for patients without peripheral neuropathy (p = 0.42). Median OS was 13 months (95% CI (10-18 months)) and 10 months (95% CI (8-13 months)) in patients with and without peripheral neuropathy, respectively (p = 0.04). DCR was achieved by 83% of patients with grade 1-2 neuropathy and by 58% of patients without neuropathy (p = 0.03). In the multivariate analysis, grade 1-2 neuropathy was independently associated with OS (HR 0.65; 95% CI, 0.45-0.98; p = 0.03). nab-P/Gem represents an optimal first-line treatment for mPC patients. Among possible treatment-related adverse events, peripheral neuropathy is the most frequent, with different grades and incidence. Our study suggests that patients experiencing CINP may have a more favorable outcome, with a higher disease control rate and prolonged median survival compared to those without neuropathy.
Association between Low-Grade Chemotherapy-Induced Peripheral Neuropathy (CINP) and Survival in Patients with Metastatic Adenocarcinoma of the Pancreas / Catalano, Martina; Aprile, Giuseppe; Ramello, Monica; Conca, Raffaele; Petrioli, Roberto; Roviello, Giandomenico. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - STAMPA. - 10:(2021), pp. 1846-1856. [10.3390/jcm10091846]
Association between Low-Grade Chemotherapy-Induced Peripheral Neuropathy (CINP) and Survival in Patients with Metastatic Adenocarcinoma of the Pancreas
Catalano, Martina;Roviello, Giandomenico
2021
Abstract
The combination of nab-paclitaxel and gemcitabine demonstrated greater efficacy than gemcitabine alone but resulted in higher rates of chemotherapy-induced peripheral neuropathy (CINP) in patients with metastatic pancreatic cancer (mPC). We aimed to evaluate the correlation between the development of treatment-related peripheral neuropathy and the efficacy of nab-P/Gem combination in these patients. mPC patients treated with nab-paclitaxel 125 mg/m(2) and gemcitabine 1000 mg/m(2) as a first-line therapy were included. Treatment-related adverse events, mainly peripheral neuropathy, were categorized using the National Cancer Institute Common Toxicity Criteria scale, version 4.02. Efficacy outcomes, including overall survival (OS), progression-free survival (PSF), and disease control rate (DCR), were estimated by the Kaplan-Meier model. A total of 153 patients were analyzed; of these, 47 patients (30.7%) developed grade 1-2 neuropathy. PFS was 7 months (95% CI (6-7 months)) for patients with grade 1-2 neuropathy and 6 months (95% CI (5-6 months)) for patients without peripheral neuropathy (p = 0.42). Median OS was 13 months (95% CI (10-18 months)) and 10 months (95% CI (8-13 months)) in patients with and without peripheral neuropathy, respectively (p = 0.04). DCR was achieved by 83% of patients with grade 1-2 neuropathy and by 58% of patients without neuropathy (p = 0.03). In the multivariate analysis, grade 1-2 neuropathy was independently associated with OS (HR 0.65; 95% CI, 0.45-0.98; p = 0.03). nab-P/Gem represents an optimal first-line treatment for mPC patients. Among possible treatment-related adverse events, peripheral neuropathy is the most frequent, with different grades and incidence. Our study suggests that patients experiencing CINP may have a more favorable outcome, with a higher disease control rate and prolonged median survival compared to those without neuropathy.
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