Analyses of updated overall survival (OS) and prognostic effect of neutrophil-to-lymphocyte ratio (NLR) and CA 19-9 from the phase III MPACT study of nab-paclitaxel (nab-P) plus gemcitabine (Gem) versus Gem for patients (pts) with metastatic pancreatic cancer (PC).

4027^ Background: In the phase III MPACT trial, nab-P + Gem demonstrated superior OS vs Gem (primary endpoint; median 8.5 vs 6.7 months; HR 0.72; Pu003c 0.001) with manageable toxicity in pts with metastatic PC. The primary analyses were based on a cutoff of Sep 17, 2012, at which time 80% of pts had died. Here, we report an updated OS analysis (post hoc) and an assessment of pts with elevated NLR or elevated CA 19-9 at baseline, 2 accepted markers of poor prognosis. Methods: 861 pts with metastatic PC and a Karnofsky performance status ≥ 70 were randomized at 151 community and academic centers 1:1 to receive nab-P 125 mg/m2 + Gem 1,000 mg/m2 on days 1, 8, and 15 of each 28-day cycle or Gem 1,000 mg/m2weekly for 7 wks followed by 1 wk of rest (cycle 1) and then days 1, 8, and 15 of each 28-day cycle (cycle ≥ 2). The data for the OS analysis were collected through May 9, 2013. Baseline NLR and CA19-9 were measured in blood samples collected before treatment. Results: As of the updated data cutoff, 380 of 431 p...