[Retrospective Analysis of Weekly Paclitaxel Chemotherapy for Gemcitabine- and S-1-Resistant Pancreatic Cancer].

Chemotherapy for unresectable pancreatic cancer has moved from using gemcitabine (GEM) and/or S-1 to using 5- fluorouracil plus Leucovorin plus oxaliplatin plus irinotecan (FOLFIRINOX) or GEM and nano albumin-bound paclitaxel (nab- PTA). We administered weekly PTA 80mg/m2 (days 1, 8, 15 every 4 weeks) in 22 patients with both GEM and S-1 resistance before nab-PTX became available through medical insurance in Japan. This regimen was used as a second-line in 3 cases, as the third-line in 14 cases and as a later line in 5 cases. The mean number of chemotherapy courses was 2.7, and the mean dose intensity was 86.1%. Postponement and dose reduction was made in 15 and 5 cases, respectively. The best overall response was 1 PR, 5 SD, 15 PD and 1 NE. The response rate was 4.5%, and disease control rate was 27.3%. The median progression-free survival was 1.7 months, and the median overall survival was 4.6 months. The main adverse events included anorexia, general malaise, and peripheral neurotoxicity and they were tolerable. This study wherein nab-PTX plus GEM was one of the standard therapies, indicated that the PTX alone was effective in pancreatic cancer patients who were resistant to GEM and S-1.