Work

Gemcitabine/nab-paclitaxel plus S-1 combination compared with gemcitabine/nab-paclitaxel in advanced pancreatic ductal adenocarcinoma: a retrospective study

Year: 2026

Type: article

Abstract: Background: Pancreatic adenocarcinoma is one of the leading causes of cancer-related mortality. The median overall survival (OS) of patients with advanced pancreatic ductal adenocarcinoma (PDAC) is less than 1 year. The recent phase III NAPOLI-3 study showed that triplet chemotherapy improved OS compared to the commonly used gemcitabine/nab-paclitaxel (GA) regimen. S-1 is widely used in Asia for the treatment of PDAC, and a combination strategy with S-1 has shown encouraging results in previous studies. Objectives: We aimed to determine whether the addition of S-1 to GA offers more benefits than GA alone as a first-line treatment for advanced PDAC. Design: This was a retrospective study of patients with advanced PDAC treated at the Taichung Veterans General Hospital, Taiwan. All patients received first-line GA-based therapy, including GA alone or GA in combination with S-1 (GAS). Methods: Retrospectively reviewed clinical characteristics and outcomes, including the objective response rate (ORR), progression-free survival (PFS), and OS, were compared between the two groups. Some patients underwent genetic testing using the FoundationOne CDx (Foundation Medicine). The effects of the treatment on major genetic alterations were also analyzed. Results: Between January 1, 2022, and February 10, 2025, 89 patients were enrolled. Among these, 45 and 44 underwent GA and GAS, respectively. The median follow-up time was 10.2 months. ORR was significantly higher in patients who received GAS than in those who did not (48% vs 18%, p = 0.001). GAS showed both significant improvement of PFS (10.0 vs 5.2 months; p = 0.004) and OS (not reached vs 8.5 months; p = 0.016) compared with GA. Multivariate analysis identified only the treatment regimen as an independent prognostic factor for OS. GAS also improved the survival of patients harboring major genetic alterations. The Grade ⩾3 hematological adverse events were more in GAS, according to the CTCAE, version 5.0. No treatment-related mortality was found. Conclusion: The S-1 could be combined with GA as another potential triplet combination treatment option for advanced PDAC.

Source: Therapeutic Advances in Medical Oncology

DOI: 10.1177/17588359261420081

Authors: Kuan-Yu Tseng, Chiann-Yi Hsu, Cheng-Han Wu, Yu-Hsuan Shih, Hsin-Chen Lin

Institutions: Taichung Veterans General Hospital, National Yang Ming Chiao Tung University, National Chung Hsing University, Chung Shan Medical University

Language: English

Topic: Pancreatic and Hepatic Oncology Research

Subfield: Oncology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,800