PT - JOURNAL ARTICLE AU - Zhu, Zhou AU - Tang, Hui AU - Ying, Jinrong AU - Cheng, Yuejuan AU - Wang, Xiang AU - Wang, Yingyi AU - Bai, Chunmei TI - Efficacy and safety of gemcitabine plus S-1 <em>vs.</em> gemcitabine plus nab-paclitaxel in treatment-naïve advanced pancreatic ductal adenocarcinoma AID - 10.20892/j.issn.2095-3941.2023.0189 DP - 2023 Oct 15 TA - Cancer Biology &amp; Medicine PG - 765--778 VI - 20 IP - 10 4099 - http://www.cancerbiomed.org/content/20/10/765.short 4100 - http://www.cancerbiomed.org/content/20/10/765.full SO - Cancer Biology &amp; Medicine2023 Oct 15; 20 AB - Objective: Gemcitabine plus nab-paclitaxel (GnP) is the standard first-line therapy for advanced pancreatic ductal adenocarcinoma (PDAC). S-1, an oral fluoropyrimidine derivative, as compared with gemcitabine, is non-inferior in terms of overall survival (OS) and is associated with lower hematologic toxicity. Accordingly, S-1 is a convenient oral alternative treatment for advanced PDAC. This study was aimed at comparing the efficacy and safety of gemcitabine plus S-1 (GS) vs. GnP as first-line chemotherapy for advanced PDAC.Methods: Patients with advanced PDAC who received first-line GS or GnP at the Peking Union Medical College Hospital between March 2011 and November 2022 were evaluated.Results: A total of 300 patients were assessed, of whom 84 received GS and 216 received GnP. The chemotherapy completion rate was higher with GS than GnP (50.0% vs. 30.3%, P = 0.0028). The objective response rate (ORR) was slightly higher (14.3% vs. 9.7%, P = 0.35), and the median OS was significantly longer (17.9 months vs. 13.3 months, P = 0.0078), in the GS group than the GnP group. However, the median progression-free survival (PFS) did not significantly differ between groups. Leukopenia risk was significantly lower in the GS group than the GnP group (14.9% vs. 28.1%, P = 0.049).Conclusions: As first-line chemotherapy for advanced PDAC, the GS regimen led to a significantly longer OS than the GnP regimen. The PFS, ORR, and incidence of severe adverse events were comparable between the GS and GnP groups.Data were generated by the authors and available on request.