Kaplan–Meier curve comparing time to deterioration in patients treated with nab-paclitaxel plus gemcitabine vs. gemcitabine alone; no significant difference in median survival.

Performance status dynamics during treatment with nab-paclitaxel plus gemcitabine versus gemcitabine alone for metastatic pancreatic cancer

Authors: E G Chiorean, D Von Hoff, Y Wan, S Margunato-Debay, M Botteman, D Goldstein

Published: Cancer Management and Research, 2018

Objectives

This analysis examined changes in Karnofsky performance status (KPS) as a surrogate for patient’s well-being during treatment with nab-paclitaxel plus gemcitabine vs gemcitabine alone as first-line therapy for metastatic pancreatic cancer (MPC) in the Phase III MPACT trial.

Participants and Methods

Descriptive analyses were performed for KPS at three time points (3 and 6 months after randomization and 1 month before disease progression) and for time to any KPS deterioration. Time to definitive KPS deterioration (?10-point KPS decrease from baseline) was calculated using the Kaplan-Meier method. A larger decrease from baseline (?20 points) was investigated as a sensitivity analysis. A Cox proportional hazards model analyzed the effect of baseline factors (including treatment) potentially associated with time to definitive deterioration.

Results

The two treatment arms had generally comparable time to any KPS deterioration, similar KPS at 3 and 6 months after randomization and at 1 month before disease progression, and no significant difference in time to definitive deterioration. Baseline KPS, neutrophil-to-lymphocyte ratio, age, liver metastases, and region had a significant effect on time to definitive KPS deterioration, but treatment arm did not.

Conclusion

The increased survival observed with nab-paclitaxel plus gemcitabine was not associated with adverse effects on performance status.