Evaluation of factors associated with drug fever following gemcitabine and nanoparticle albumin-bound paclitaxel treatment for pancreatic cancer.

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.