Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
Evaluation of factors associated with drug fever following gemcitabine and nanoparticle albumin-bound paclitaxel treatment for pancreatic cancer.
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Saito Yoshitaka, Takekuma Yoh, Komatsu Yoshito, Sugawara Mitsuru
Аннотация
PURPOSE: Gemcitabine (GEM) + nanoparticle albumin-bound paclitaxel (nab-PTX) is an effective treatment for advanced pancreatic cancer. However, drug fever is a frequently observed adverse effect of GEM, and PTX can also induce symptoms. This study aimed to identify factors for drug fever in the real-world treatment of pancreatic cancer with GEM + nab-PTX.
METHODS: We retrospectively assessed patients with pancreatic cancer who received GEM + nab-PTX (n = 386). The primary endpoint was the identification of factor(s) associated with the incidence of drug fever following the first administration. We also assessed symptoms between specific patient groups.
RESULTS: The incidence of drug fever following the first GEM + nab-PTX treatment was 12.7%. The median onset time was day 3 (range: 1-4) with a symptom duration of 1 (1-6) day. Unresectable setting (adjusted odds ratio [95% confidence interval]: 3.35 [1.35-8.32], P = 0.009) and elevated baseline C-reactive protein (CRP) levels (≥ 1.0 mg/dL) (3.55 [1.80-6.98], P = 0.0002) were identified as risk factors using the multivariable logistic regression analysis. Patients receiving regular antipyretic treatment with non-steroidal anti-inflammatory drugs (NSAIDs) and/or acetaminophen had a lower risk (0.42 [0.20-0.87], P = 0.02). No difference was observed in the impact of the type of antipyretics on drug fever between NSAIDs and acetaminophen.
CONCLUSION: An unresectable disease status and high baseline CRP levels are risk factors for drug-induced fever, while patients receiving regular antipyretics are at lower risk of developing these symptoms during real-world treatment of pancreatic cancer with GEM + nab-PTX.
METHODS: We retrospectively assessed patients with pancreatic cancer who received GEM + nab-PTX (n = 386). The primary endpoint was the identification of factor(s) associated with the incidence of drug fever following the first administration. We also assessed symptoms between specific patient groups.
RESULTS: The incidence of drug fever following the first GEM + nab-PTX treatment was 12.7%. The median onset time was day 3 (range: 1-4) with a symptom duration of 1 (1-6) day. Unresectable setting (adjusted odds ratio [95% confidence interval]: 3.35 [1.35-8.32], P = 0.009) and elevated baseline C-reactive protein (CRP) levels (≥ 1.0 mg/dL) (3.55 [1.80-6.98], P = 0.0002) were identified as risk factors using the multivariable logistic regression analysis. Patients receiving regular antipyretic treatment with non-steroidal anti-inflammatory drugs (NSAIDs) and/or acetaminophen had a lower risk (0.42 [0.20-0.87], P = 0.02). No difference was observed in the impact of the type of antipyretics on drug fever between NSAIDs and acetaminophen.
CONCLUSION: An unresectable disease status and high baseline CRP levels are risk factors for drug-induced fever, while patients receiving regular antipyretics are at lower risk of developing these symptoms during real-world treatment of pancreatic cancer with GEM + nab-PTX.