Nab-paclitaxel and gemcitabine plus camrelizumab and radiotherapy versus nab-paclitaxel and gemcitabine alone for locally advanced pancreatic adenocarcinoma: a prospective cohort study
Abstract Treatment options specifically for patients with locally advanced pancreatic adenocarcinoma (LAPC) are scare and chemotherapy alone delivers limited efficacy. Immunotherapy and radiotherapy are potential effective treatments for LAPC, and both of them may synergize with chemotherapy. Theref...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | Journal of Hematology & Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13045-023-01422-8 |
| _version_ | 1827983016489648128 |
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| author | Shuling Chen Jiaxin Li Aoran Dong Zelong Liu Meiyan Zhu Meng Jin Guangyan Wei Shuang Wu Yan Wang Yong Chen Zhenwei Peng |
| author_facet | Shuling Chen Jiaxin Li Aoran Dong Zelong Liu Meiyan Zhu Meng Jin Guangyan Wei Shuang Wu Yan Wang Yong Chen Zhenwei Peng |
| author_sort | Shuling Chen |
| collection | DOAJ |
| description | Abstract Treatment options specifically for patients with locally advanced pancreatic adenocarcinoma (LAPC) are scare and chemotherapy alone delivers limited efficacy. Immunotherapy and radiotherapy are potential effective treatments for LAPC, and both of them may synergize with chemotherapy. Therefore, in this prospective cohort study, we compared the efficacy and safety of nab-paclitaxel plus gemcitabine combined with anti-programmed cell death (PD-1) immunotherapy and radiotherapy (hereafter, combination treatment) versus nab-paclitaxel plus gemcitabine (chemotherapy alone) in the treatment of LAPC. In the combination group, participants received conventional fractionated radiotherapy with doses ranging from 54 to 63 Gy in 28 fractions, intravenous camrelizumab 200 mg once every 3 weeks, and intravenous nab-paclitaxel plus gemcitabine on day 1 and 8 of a 21-day cycle for eight cycles until disease progression, death or unacceptable toxicity. In the chemotherapy group, participants received intravenous nab-paclitaxel plus gemcitabine on day 1 and 8 of a 21-day cycle for eight cycles. From April, 2020 to December, 2021, 96 participants with LAPC were prospectively enrolled with 32 received combination treatment and 64 received chemotherapy alone at a single center. The combination treatment yielded significantly longer median overall-survival (22.3 months vs. 18.6 months, P = 0.031) and progression-free survival (12.0 months vs. 10.5 months, P = 0.043) than chemotherapy alone did. And the incidence of severe adverse events was not significantly different between the combination group and chemotherapy group (P = 0.856). In conclusion, nab-paclitaxel plus gemcitabine combined with anti-PD-1 immunotherapy and radiotherapy was effective and safe for LAPC patients, and it warrants further investigation in larger randomized trials. |
| first_indexed | 2024-04-09T22:41:09Z |
| format | Article |
| id | doaj.art-08e080f269194ebdb4563ab255c6ac05 |
| institution | Directory Open Access Journal |
| issn | 1756-8722 |
| language | English |
| last_indexed | 2024-04-09T22:41:09Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Hematology & Oncology |
| spelling | doaj.art-08e080f269194ebdb4563ab255c6ac052023-03-22T12:07:44ZengBMCJournal of Hematology & Oncology1756-87222023-03-011611410.1186/s13045-023-01422-8Nab-paclitaxel and gemcitabine plus camrelizumab and radiotherapy versus nab-paclitaxel and gemcitabine alone for locally advanced pancreatic adenocarcinoma: a prospective cohort studyShuling Chen0Jiaxin Li1Aoran Dong2Zelong Liu3Meiyan Zhu4Meng Jin5Guangyan Wei6Shuang Wu7Yan Wang8Yong Chen9Zhenwei Peng10Institute of Diagnostic and Interventional Ultrasound, Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-Sen UniversityDepartment of Radiation Oncology, The First Affiliated Hospital, Sun Yat-Sen UniversityDepartment of Radiation Oncology, The First Affiliated Hospital, Sun Yat-Sen UniversityDepartment of Radiation Oncology, The First Affiliated Hospital, Sun Yat-Sen UniversityDepartment of Radiation Oncology, The First Affiliated Hospital, Sun Yat-Sen UniversityDepartment of Radiation Oncology, The First Affiliated Hospital, Sun Yat-Sen UniversityDepartment of Radiation Oncology, The First Affiliated Hospital, Sun Yat-Sen UniversityDepartment of Radiation Oncology, The First Affiliated Hospital, Sun Yat-Sen UniversityDepartment of Radiation Oncology, The First Affiliated Hospital, Sun Yat-Sen UniversityDepartment of Radiation Oncology, The First Affiliated Hospital, Sun Yat-Sen UniversityDepartment of Radiation Oncology, The First Affiliated Hospital, Sun Yat-Sen UniversityAbstract Treatment options specifically for patients with locally advanced pancreatic adenocarcinoma (LAPC) are scare and chemotherapy alone delivers limited efficacy. Immunotherapy and radiotherapy are potential effective treatments for LAPC, and both of them may synergize with chemotherapy. Therefore, in this prospective cohort study, we compared the efficacy and safety of nab-paclitaxel plus gemcitabine combined with anti-programmed cell death (PD-1) immunotherapy and radiotherapy (hereafter, combination treatment) versus nab-paclitaxel plus gemcitabine (chemotherapy alone) in the treatment of LAPC. In the combination group, participants received conventional fractionated radiotherapy with doses ranging from 54 to 63 Gy in 28 fractions, intravenous camrelizumab 200 mg once every 3 weeks, and intravenous nab-paclitaxel plus gemcitabine on day 1 and 8 of a 21-day cycle for eight cycles until disease progression, death or unacceptable toxicity. In the chemotherapy group, participants received intravenous nab-paclitaxel plus gemcitabine on day 1 and 8 of a 21-day cycle for eight cycles. From April, 2020 to December, 2021, 96 participants with LAPC were prospectively enrolled with 32 received combination treatment and 64 received chemotherapy alone at a single center. The combination treatment yielded significantly longer median overall-survival (22.3 months vs. 18.6 months, P = 0.031) and progression-free survival (12.0 months vs. 10.5 months, P = 0.043) than chemotherapy alone did. And the incidence of severe adverse events was not significantly different between the combination group and chemotherapy group (P = 0.856). In conclusion, nab-paclitaxel plus gemcitabine combined with anti-PD-1 immunotherapy and radiotherapy was effective and safe for LAPC patients, and it warrants further investigation in larger randomized trials.https://doi.org/10.1186/s13045-023-01422-8RadiotherapyImmunotherapyChemotherapyLocally advanced pancreatic adenocarcinoma |
| spellingShingle | Shuling Chen Jiaxin Li Aoran Dong Zelong Liu Meiyan Zhu Meng Jin Guangyan Wei Shuang Wu Yan Wang Yong Chen Zhenwei Peng Nab-paclitaxel and gemcitabine plus camrelizumab and radiotherapy versus nab-paclitaxel and gemcitabine alone for locally advanced pancreatic adenocarcinoma: a prospective cohort study Journal of Hematology & Oncology Radiotherapy Immunotherapy Chemotherapy Locally advanced pancreatic adenocarcinoma |
| title | Nab-paclitaxel and gemcitabine plus camrelizumab and radiotherapy versus nab-paclitaxel and gemcitabine alone for locally advanced pancreatic adenocarcinoma: a prospective cohort study |
| title_full | Nab-paclitaxel and gemcitabine plus camrelizumab and radiotherapy versus nab-paclitaxel and gemcitabine alone for locally advanced pancreatic adenocarcinoma: a prospective cohort study |
| title_fullStr | Nab-paclitaxel and gemcitabine plus camrelizumab and radiotherapy versus nab-paclitaxel and gemcitabine alone for locally advanced pancreatic adenocarcinoma: a prospective cohort study |
| title_full_unstemmed | Nab-paclitaxel and gemcitabine plus camrelizumab and radiotherapy versus nab-paclitaxel and gemcitabine alone for locally advanced pancreatic adenocarcinoma: a prospective cohort study |
| title_short | Nab-paclitaxel and gemcitabine plus camrelizumab and radiotherapy versus nab-paclitaxel and gemcitabine alone for locally advanced pancreatic adenocarcinoma: a prospective cohort study |
| title_sort | nab paclitaxel and gemcitabine plus camrelizumab and radiotherapy versus nab paclitaxel and gemcitabine alone for locally advanced pancreatic adenocarcinoma a prospective cohort study |
| topic | Radiotherapy Immunotherapy Chemotherapy Locally advanced pancreatic adenocarcinoma |
| url | https://doi.org/10.1186/s13045-023-01422-8 |
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