Sally Temraz - Department of Internal Medicine, Hematology/Oncology Division, American University of Beirut Medical Center, Beirut, Lebanon
Firas Kreidieh - Department of Internal Medicine, Hematology/Oncology Division, American University of Beirut Medical Center, Beirut, Lebanon
Farah Nassar - Department of Internal Medicine, Hematology/Oncology Division, American University of Beirut Medical Center, Beirut, Lebanon
Maria Mezher - Department of Internal Medicine, Hematology/Oncology Division, American University of Beirut Medical Center, Beirut, Lebanon
Deborah Mukherji - Department of Internal Medicine, Hematology/Oncology Division, American University of Beirut Medical Center, Beirut, Lebanon
Ali Shamseddine - Department of Internal Medicine, Hematology/Oncology Division, American University of Beirut Medical Center, Beirut, Lebanon

Background: Pancreatic cancer is characterized by its generally poor prognosis and ranks seventh worldwide in cancer-related mortality. We previously conducted a prospective study on the use of modified GTX regimen (a combination of gemcitabine, docetaxel, and capecitabine), which has appreciable activity and is well-tolerated, in this setting. We compared the efficacy of GTX regimen versus Gemcitabine-nabpaclitaxel (GmAb) as second-line chemotherapy in advanced pancreatic cancer patients receiving first-line therapy with FOLFIRINOX.Method: This retrospective chart review aimed to collect and record data corresponding to patients diagnosed with advanced pancreatic cancer at the American University of Beirut Medical Center who received FOLFIRINOX as first-line chemotherapy and who then had GTX or GmAb as second-line treatment between ۲۰۱۳ and ۲۰۱۹. We measured the progression-free survival, overall survival, and toxicity of GTX versus GmAb as second-line treatment for pancreatic adenocarcinoma at AUBMC.Results: The median overall survival for the GmAb group was around ۵۲ months, which is greater than that of the GTX group, which was ۲۵ months. ۲۶.۷% of patients who received GTX required dose reduction starting from cycle one, while only ۳.۱% of those who received GmAb required dose reduction from cycle one. ۳۸.۷% of patients who received GmAb did not have anemia throughout the course of treatment, while the majority of patients who received GTX, ۹۳.۳%, had grade I anemia.Conclusion: Our data show that GmAb is a possibly better second-line treatment option than GTX with better tolerance to the dose, less anemia, and a better survival profile. More studies are needed with a larger sample size and a prospective design to prove such a possible difference between the two regimens.

Gemcitabine, FOLFIRINOX, Pancreatic Neoplasms, second-line chemotherapy