A Case Series of Patients with Pancreatic Cancer and Cholangiocarcinoma Treated with <i>nab</i>-Paclitaxel at a Single Institution

Abstract

Background: Locally advanced or metastatic pancreatic cancer patients have a poor prognosis with median survival less than 12 months. Nanoparticle albumin bound ( nab )-paclitaxel is a novel agent that has demonstrated antitumor effects in cancers that overexpress the albumin binding protein SPARC (secreted protein acidic and rich in cysteine), which includes pancreatic cancer. A recent phase III trial comparing nab -paclitaxel and gemcitabine to gemcitabine alone demonstrated a survival advantage in patients with previously untreated metastatic pancreatic cancer. Here we present our local experience with this drug in patients with gastrointestinal malignancies. Methods: Patients treated with nab -paclitaxel for gastrointestinal malignancies at the Cross Cancer Institute in Edmonton, Alberta, Canada were identified and these patient’s medical records were interrogated for data. Results: Three patients with pancreatic cancer and two with cholangiocarcinoma have been treated with nab -paclitaxel at the Cross Cancer Institute. Three patients achieved stable disease, while one had a partial response, and one had progressive disease after the first assessment. Median time to progression was 3.7 months. Median overall survival (OS) was 32.5 months. Median OS from initiation of nab -paclitaxel was 7.2 months. Patients tolerated treatment with nab -paclitaxel well with only one patient requiring treatment modification due to neutropenia. Conclusion: The experience at this single center supports published evidence that nab -paclitaxel is a safe and effective therapy in pancreatic cancer, but also suggests that it may have activity in cholangiocarcinoma, which to our knowledge is the first published evidence of this in humans.