Dr. Ramanathan Discusses the Phase III MPACT Trial

Ramesh K. Ramanathan, MD, Medical Director of the Virginia G. Piper Cancer Center Clinical Trials Program at Scottsdale Healthcare, discusses the phase III MPACT study that examined gemcitabine plus nab-paclitaxel (Abraxane) in patients with metastatic adenocarcinoma of the pancreas.

Ramanathan notes that the MPACT trial is the largest trial to be conducted in patients with pancreatic cancer. He adds that the trial was a large international, multi-institution, trial that provided very promising results for the combination, which has been a long sought after goal in pancreatic cancer.

In the trial, 842 patients were enrolled and randomized to receive the combination of nab-paclitaxel at 125 mg/m² followed by gemcitabine at 1000 mg/m² or gemcitabine alone. The median overall survival was 8.5 months for the combination compared to 6.7 for gemcitabine alone (HR = 0.72; P = .000015). Moreover, the time to treatment failure was significantly prolonged with the combination from 3.5 months to 5.1 (HR = 0.70; P < .0001).

Ramanathan notes that, as expected, there was more toxicity with the combination of nab-paclitaxel and gemcitabine than gemcitabine alone. The most common grade 3 adverse events were neutropenia, fatigue, and neuropathy. The rate of febrile neutropenia was 3% for the combination compared to 1% for the single agent.

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