To investigate the efficacy and safety of albumin bound paclitaxel in the treatment of metastatic pancreatic cancer with first-line gemcitabine based chemotherapy failure.

A total of 50 patients with metastatic pancreatic cancer after first-line gemcitabine based chemotherapy failure in Huairou Hospital of Beijing from January 2014 to July 2020 were divided into two groups according to different treatment regimens. 25 cases in the control group were treated with mFOLFOX6 regimen, while 25 cases in the observation group were treated with albumin bound paclitaxel regimen. The clinical characteristics, treatment methods, short-and long-term effects and adverse reactions of the two groups were analyzed retrospectively.

After two cycles of treatment, there were 0 case of complete remission (CR), 10 cases of partial remission (PR), 12 cases of stable disease (SD), and 3 cases of disease progression (PD), the objective response rate (ORR) was 40.0%, and the disease control rate (DCR) was 88.0% in the control group. In the observation group, there were 0 case of CR, 12 cases of PR, 11 cases of SD and 2 cases of PD, ORR was 48.0%, DCR was 92.0%. There were no significant differences in ORR and DCR between the two groups (χ²=0.325, P=0.569; χ²=0.222, P=0.637). The median progression free survival (PFS) of the control group and the observation group were 4.2 months (95% CI: 3.711-4.692 months) and 4.6 months (95% CI: 3.765-5.435 months), respectively. The median overall survival (OS) was 7.4 months (95% CI: 7.050-7.750 months) and 7.9 months (95% CI: 7.679-8.121 months), respectively. There were no significant differences in PFS and OS of the two groups ( χ²=0.419, P=0.517; χ²=2.978, P=0.084). The chemotherapy tolerance of the observation group was better than that of the control group. The main adverse reactions were neutropenia (16.0%), anemia (12.0%), sensory neurotoxicity (40.0%), asthenia (20.0%), liver function damage (12.0%), nausea (8.0%) and diarrhea (12.0%). The incidence of grade 3 and 4 adverse reactions in the observation group was significantly lower than that in the control group (P<0.05).

Albumin bound paclitaxel regimen is comparable to the mFOLFOX6 regimen in the treatment of first-line resistant metastatic pancreatic cancer and the adverse reactions are low.