title: Nab-paclitaxel monotherapy in refractory pancreatic adenocarcinoma.
abstract: BACKGROUND
  The standard of care in patients with metastatic pancreatic adenocarcinoma is undefined beyond second line of treatment. There have been scant reports of benefit from nab-paclitaxel in patients with refractory pancreatic cancer.
  
  
  METHODS
  A retrospective review was carried out in patients with pancreatic adenocarcinoma at Siteman Cancer Center, who had received nab-paclitaxel monotherapy after experiencing disease progression on standard treatments. Nab-paclitaxel was given either two out of every three weeks or three out of every four weeks.
  
  
  RESULTS
  Twenty patients were identified and included for data analysis. Median age was 63.5 years old. All patients had previously received gemcitabine, while 40% had also received FOLFIRINOX. Median number of prior lines of systemic treatment was 2. Patients were treated for a median of 15 weeks, with a range of 1 to 41.7 weeks. Median dose of nab-paclitaxel was 100 mg/m(2) with range of 75-125 mg/m(2). Best response imaging was available in 17 patients and 11 out of the 17 patients (64.7%) had stable disease. Median progression-free survival (PFS) was 3.7 months and overall survival (OS) were 5.2 months. Most common treatment related toxicities included grade 1 pneumonitis in five patients (25%), grade 3 or 4 neutropenia in three patients (15%), and dehydration resulting in hospitalization in one patient (5%).
  
  
  CONCLUSIONS
  Nab-paclitaxel monotherapy had acceptable level of toxicity in a heavily pretreated patient population with pancreatic cancer and appeared to provide a clinical benefit. This agent is worthy of further prospective studies to evaluate extent of benefit after standard therapies have failed.
authors.affiliation: Division of Medical Oncology, Department of Medicine, Washington University School of Medicine, Saint Louis, Missouri 63110, USA; ; Division of Hematology-Oncology, University of California, Los Angeles, 90095, USA;
authors.forename: Parvin F
authors.initials: PF
authors.lastname: Peddi
authors.forename: May
authors.initials: M
authors.lastname: Cho
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.forename: Feng
authors.initials: F
authors.lastname: Gao
authors.forename: Andrea
authors.initials: A
authors.lastname: Wang-Gillam
keywords: Pancreatic adenocarcinoma; monotherapy; nab-paclitaxel; refractory disease; registry study