{
  "abstract": "• Relative dose intensity (RDI) of gemzar-nab-paclitaxel (GNP) has not been reported in second line and more in advanced pancreatic carcinoma. • The RDI is relatively low with 50 % of patients who received GNP at a RDI ≥70 % during the first months of treatment resulting of treatment schedule modification in two third of cases and a full dose in only 15 %. • There was no significant difference in prognosis between RDI <70 % and ≥70 % supporting that alternative GNP regimens may be of interest in that setting. Gemcitabine-nab-paclitaxel (GNP) is widely used in treating advanced or metastatic pancreatic adenocarcinoma (a/mPA), but no data are available regarding its relative dose intensity (RDI) beyond the first line. To assess the impact of the RDI of GNP as second-line or greater therapy (L2+) for a/mPA. Patients with a/mPA undergoing L2+ treatment were retrospectively included. The RDI was analysed from the start of GNP to the first CT scan. Overall survival (OS), progression-free survival (PFS) and toxicity were analysed according to the RDI at a predefined threshold of 70 %. A total of 116 patients were included, with a median RDI of 70 % (range, 20 %-114 %). There was no significant difference in OS or PFS between RDI<70 % and ≥70 %, with median of 7.0 and 8.1 months (adjusted HR = 1.35; CI95 % [0.89–2.05]; p = 0.2) and 3.1 vs 3.4 months (adjusted HR = 1.36; CI95 % [0.91–2.05]; p = 0.14), respectively. Grade ≥3 toxicities were more common in RDI <70 % as compared to RDI ≥70 % (56.9 % vs. 37.9 %, p = 0.04) and responsible for more GNP dose reductions (67.7 % vs. 50 %, p = 0.13) and schedule modifications (72.4 % vs. 48.2 %, p = 0.008). Our results suggest that the level of GNP exposure, at a predefined RDI threshold of 70 %, had no significant effect on survival in our patients treated in L2+ for a/mPA. Alternative GNP regimens may be evaluated in patients undergoing L2+ treatment for a/mPA.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "name": "Adrien Grancher"
    },
    {
      "name": "Leila Tagemouati"
    },
    {
      "name": "André Gillibert"
    },
    {
      "name": "Lilian Schwarz"
    },
    {
      "name": "Virginie Vernon"
    },
    {
      "name": "David Sefrioui"
    },
    {
      "name": "Pierre Michel"
    },
    {
      "name": "Marie Dutherage"
    },
    {
      "name": "Frédéric Di Fiore"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9kwkht8ve8hjy.bib",
  "cited_by": 2,
  "doi": "10.1016/j.clinre.2025.102583",
  "fulltext_url": null,
  "id": "9kwkht8ve8hjy",
  "issns": [
    "2210-7401",
    "2210-741X"
  ],
  "landing_url": "https://hal.science/hal-05742246v1",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "hal",
      "0.sdv"
    ],
    [
      "hal",
      "1.sdv.mhep"
    ],
    [
      "hal",
      "2.sdv.mhep.heg"
    ],
    [
      "openalex",
      "2730|Pancreatic and Hepatic Oncology Research"
    ]
  ],
  "openalex": "W4408975203",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-08",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/9kwkht8ve8hjy.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:31Z",
      "native_id": "hal-05742246",
      "source": "hal",
      "url": "https://hal.science/hal-05742246v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2730|Pancreatic and Hepatic Oncology Research",
      "subfield": "oncology"
    }
  ],
  "title": "Relative dose intensity of gemcitabine-nab-paclitaxel combination as second-line or more in locally advanced or metastatic pancreatic adenocarcinoma",
  "title_text": "Relative dose intensity of gemcitabine-nab-paclitaxel combination as second-line or more in locally advanced or metastatic pancreatic adenocarcinoma",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:31Z",
  "url": "https://research.draconitic.com/paper/9kwkht8ve8hjy",
  "venue": "Clinics and Research in Hepatology and Gastroenterology",
  "versions": []
}