Evidence map›Paper›PMID 26802160›Full record

Trial reportAnnals of oncology : official journal of the European Society for Medical Oncology2016

CA19-9 decrease at 8 weeks as a predictor of overall survival in a randomized phase III trial (MPACT) of weekly nab-paclitaxel plus gemcitabine versus gemcitabine alone in patients with metastatic pancreatic cancer.

E G Chiorean, D D Von Hoff, M Reni, F P Arena, J R Infante, V G Bathini, T E Wood, P N Mainwaring, R T Muldoon, P R Clingan and 7 more

3 registry-linked trialsOpen access · bronzeAbstract readClinical Trial, Phase IIIRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Annals of oncology : official journal of the European Society for Medical Oncology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 62 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
62citing papers in PubMed, 1 pooled it
6.3field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00844649 phase3completednot on this map

A Randomized Phase III Study of Weekly ABI-007 Plus Gemcitabine Versus Gemcitabine Alone in Patients With Metastatic Adenocarcinoma of the Pancreas

TypeinterventionalSponsorCelgeneRan2009 to 2013Enrolled861ConditionsMetastatic Pancreatic CancerArmsAlbumin-bound paclitaxel (ABI-007), Gemcitabine
NCT02021500 completednot on this map

MPACT Extension Study: Multicenter, Survival Data Collection in Subjects Previously Enrolled in Protocol CA046

TypeobservationalSponsorCelgeneRan2014 to 2015Enrolled40ConditionsPancreatic CancerArmsABI-007
NCT05168527 phase2unknown statusnot on this mapstarted 2021, after this paper: background citation

An Open Single-center Phase II Clinical Study of Fruquintinib Combined With Chemotherapy in Patients With Liver Metastases From Pancreatic Cancer

TypeinterventionalSponsorFudan UniversityRan2021 to 2024Enrolled30ConditionsPancreatic CancerArmsFruquintinib,Albumin Paclitaxel,Gemcitabine
3 · Its place in the literature

Who cites it

62 citing papers in PubMed, 1 synthesis or guideline pooled it, 101 citations in OpenAlex.

  1. Pooled it
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  13. The Prognostic Impact of Early ctDNA Kinetics in Metastatic Pancreatic Cancer Using the ctDNA-RECIST.Clinical cancer research : an official journal of the American Association for Cancer Research · 2025
    Article
  14. Review
  15. Risk Stratification and Prognosis Determination Based on Protein Lysine Crotonylation in Patients with Resected Pancreatic Cancer: A Multicenter Study.Clinical cancer research : an official journal of the American Association for Cancer Research · 2025
    Article
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2 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors at 9 institutions in 5 countries.

E G ChioreanDepartment of Medicine/Oncology, University of Washington, Fred Hutchinson Cancer Research Center, Seattle gchiorea@uw.edu.
D D Von HoffHonorHealth and The Translational Genomics Research Institute (TGen), Scottsdale, USA.
M ReniDepartment of Radiation Oncology, San Raffaele Scientific Institute, Milan, Italy.
F P ArenaDepartment of Oncology, NYU Langone Arena Oncology, Lake Success.
J R InfanteSarah Cannon Research Institute, Tennessee Oncology, PLLC, Nashville.
V G BathiniCancer Center of Excellence, University of Massachusetts Medical School, Worcester.
T E WoodUAB Comprehensive Cancer Center, Birmingham, USA.
P N MainwaringMater Private Centre for Haematology & Oncology, South Brisbane, Australia.
R T MuldoonDepartment of Oncology, Genesis Cancer Center, Hot Springs, USA.
P R ClinganSouthern Medical Day Care Centre, Wollongong, Australia.
V KunzmannMedizinische Klinik und Poliklinik II, University of Wuerzburg, Wuerzburg, Germany.
R K RamanathanHonorHealth and The Translational Genomics Research Institute (TGen), Scottsdale, USA.
J TaberneroMedical of Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Universitat Autònoma de Barcelona, Barcelona, Spain.
D GoldsteinDepartment of Oncology, Prince of Wales Hospital, Sydney, Australia.
D McGovernCelgene Corporation, Summit, USA.
B LuCelgene Corporation, Summit, USA.
A KoCelgene Corporation, Summit, USA.
HonorHealth · USPrince of Wales Hospital · AUSan Raffaele University of Rome · ITSylvester Comprehensive Cancer Center · USTennessee Oncology · USUniversitat Autònoma de Barcelona · ESUniversity of Massachusetts Chan Medical School · USUniversity of Washington · USUniversity of Würzburg · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA phase I/II study and subsequent phase III study (MPACT) reported significant correlations between CA19-9 decreases and prolonged overall survival (OS) with nab-paclitaxel plus gemcitabine (nab-P + Gem) treatment for metastatic pancreatic cancer (MPC). CA19-9 changes at week 8 and potential associations with efficacy were investigated as part of an exploratory analysis in the MPACT trial. PATIENTS AND

methodsUntreated patients with MPC (N = 861) received nab-P + Gem or Gem alone. CA19-9 was evaluated at baseline and every 8 weeks.

resultsPatients with baseline and week-8 CA19-9 measurements were analyzed (nab-P + Gem: 252; Gem: 202). In an analysis pooling the treatments, patients with any CA19-9 decline (80%) versus those without (20%) had improved OS (median 11.1 versus 8.0 months; P = 0.005). In the nab-P + Gem arm, patients with (n = 206) versus without (n = 46) any CA19-9 decrease at week 8 had a confirmed overall response rate (ORR) of 40% versus 13%, and a median OS of 13.2 versus 8.3 months (P = 0.001), respectively. In the Gem-alone arm, patients with (n = 159) versus without (n = 43) CA19-9 decrease at week 8 had a confirmed ORR of 15% versus 5%, and a median OS of 9.4 versus 7.1 months (P = 0.404), respectively. In the nab-P + Gem and Gem-alone arms, by week 8, 16% (40/252) and 6% (13/202) of patients, respectively, had an unconfirmed radiologic response (median OS 13.7 and 14.7 months, respectively), and 79% and 84% of patients, respectively, had stable disease (SD) (median OS 11.1 and 9 months, respectively). Patients with SD and any CA19-9 decrease (158/199 and 133/170) had a median OS of 13.2 and 9.4 months, respectively.

conclusionThis analysis demonstrated that, in patients with MPC, any CA19-9 decrease at week 8 can be an early marker for chemotherapy efficacy, including in those patients with SD. CA19-9 decrease identified more patients with survival benefit than radiologic response by week 8.

Indexed as

AdenocarcinomaAdultAgedAlbuminsBiomarkers, PharmacologicalCA-19-9 AntigenDeoxycytidineDisease-Free SurvivalFemaleGemcitabineHumansMaleMiddle AgedPaclitaxelPancreatic NeoplasmsTreatment Outcome130-nm albumin-bound paclitaxelAlbuminsBiomarkers, PharmacologicalCA-19-9 AntigenDeoxycytidineGemcitabinePaclitaxelCA19-9chemotherapyMPACTnab-paclitaxelpancreatic cancer

Identifiers

PMID26802160
PMCPMC4803454
OpenAlexW2285607949

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.