title: Preoperative treatment with gemcitabine plus nab-paclitaxel is a safe and effective chemotherapy for pancreatic adenocarcinoma.
abstract: BACKGROUND
  Recently, novel chemotherapeutic agents like nab-paclitaxel and gemcitabine demonstrated a survival benefit over gemcitabine alone in metastatic pancreatic cancer. However, there are limited clinical results using this chemotherapy in potentially resectable pancreatic adenocarcinoma. Our aim is to report the oncological results of patients affected by potentially resectable pancreatic adenocarcinoma that underwent surgery after a combination of gemcitabine and nab-paclitaxel.
  
  
  METHODS
  A total of 25 patients have been included. We evaluated: (1) Drug toxicity; (2) tumoral response (tumoral size at CT scan, SUV of FDG PET-CT scan and CA 19.9; (3) resection rate; (4) R0 resection rate and histopathological response and (5) survival and disease free survival.
  
  
  RESULTS
  Overall treatment was well tolerated. Treatment resulted in a statistical decrease of CA19-9 (p = 0.019) tumoral size (p = 0.04) and SUV (p = 0.004). The resection rate was 68% (17/25 patients). All specimens were R0 and 13 of 17 specimens had major pathological regressions (complete and important response). Median survival and medial disease free survival of patients that underwent surgery was 21 months and 19 months, respectively at a mean follow up of 38.5 months.
  
  
  CONCLUSIONS
  This data suggests that nab-paclitaxel and gemcitabine is a safe and effective neoadjuvant treatment for potentially resectable pancreatic adenocarcinoma. This promising data should be confirmed in larger, randomized studies.
authors.affiliation: General Surgery, Oncological Center Clara Campal, Sanchinarro University Hospital, Calle Oña 10, 28050 Madrid, Spain. Electronic address: ielpo.b@gmail.com.
authors.forename: B
authors.initials: B
authors.lastname: Ielpo
authors.affiliation: General Surgery, Oncological Center Clara Campal, Sanchinarro University Hospital, Calle Oña 10, 28050 Madrid, Spain.
authors.forename: H
authors.initials: H
authors.lastname: Duran
authors.affiliation: General Surgery, Oncological Center Clara Campal, Sanchinarro University Hospital, Calle Oña 10, 28050 Madrid, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Diaz
authors.affiliation: General Surgery, Oncological Center Clara Campal, Sanchinarro University Hospital, Calle Oña 10, 28050 Madrid, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Fabra
authors.affiliation: General Surgery, Oncological Center Clara Campal, Sanchinarro University Hospital, Calle Oña 10, 28050 Madrid, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Caruso
authors.affiliation: General Surgery, Oncological Center Clara Campal, Sanchinarro University Hospital, Calle Oña 10, 28050 Madrid, Spain.
authors.forename: V
authors.initials: V
authors.lastname: Ferri
authors.affiliation: General Surgery, Oncological Center Clara Campal, Sanchinarro University Hospital, Calle Oña 10, 28050 Madrid, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Malavé
authors.affiliation: General Surgery, Oncological Center Clara Campal, Sanchinarro University Hospital, Calle Oña 10, 28050 Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Hidalgo
authors.affiliation: General Surgery, Oncological Center Clara Campal, Sanchinarro University Hospital, Calle Oña 10, 28050 Madrid, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Alvarez
authors.affiliation: General Surgery, Oncological Center Clara Campal, Sanchinarro University Hospital, Calle Oña 10, 28050 Madrid, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Plaza
authors.affiliation: General Surgery, Oncological Center Clara Campal, Sanchinarro University Hospital, Calle Oña 10, 28050 Madrid, Spain.
authors.forename: Y
authors.initials: Y
authors.lastname: Quijano
authors.affiliation: General Surgery, Oncological Center Clara Campal, Sanchinarro University Hospital, Calle Oña 10, 28050 Madrid, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Vicente
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D000368:Aged; D000418:Albumins / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018395:CA-19-9 Antigen / Q000097:blood; D015331:Cohort Studies; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D017239:Paclitaxel / Q000008:administration & dosage; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D000072078:Positron Emission Tomography Computed Tomography; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D047368:Tumor Burden; D000093542:Gemcitabine
chemical_list: C520255:130-nm albumin-bound paclitaxel; D000418:Albumins; D018395:CA-19-9 Antigen; D003841:Deoxycytidine; D017239:Paclitaxel; D000093542:Gemcitabine
keywords: Neoadjuvant treatment; Pancreatectomy; Pancreatic cancer