Identification of factors associated with rash during gemcitabine plus nanoparticle albumin-bound paclitaxel treatment for pancreatic cancer.

BACKGROUND

Rash is a frequently observed adverse effect of gemcitabine (GEM) plus nanoparticle albumin-bound paclitaxel (nab-PTX) therapy for pancreatic cancer. However, the clinical characteristics of this reaction remain poorly understood. In this study, we aimed to identify factors associated with the development of rash during GEM plus nab-PTX therapy for pancreatic cancer in a real-world setting.

METHODS

Patients with pancreatic cancer receiving GEM plus nab-PTX (n = 313) were retrospectively evaluated. The primary endpoint was to identify factors associated with all-grade rash during the first cycle. The secondary endpoint was the change in eosinophil levels from baseline to the nearest assessment time point after rash development in patients who developed symptoms.

RESULTS

The incidence of all-grade rash was 20.4%, with grades 1 and 2 accounting for 18.5% and 1.9%, respectively. Multivariable logistic regression analysis identified baseline renal impairment as an independent risk factor and the regular co-administration of non-steroidal anti-inflammatory drugs (NSAIDs) as a protective factor for rash development (adjusted odds ratio [95% confidence interval]: 2.01 [1.03-3.91], P = 0.04 for renal impairment; and 0.44 [0.20-0.91], P = 0.03 for NSAID co-administration). Eosinophilia at the nearest time point after symptom onset occurred in 12.5% of patients with rash, with eosinophil levels significantly elevated from baseline, suggesting partial involvement of an immune-mediated mechanism.

CONCLUSION

Our study identified baseline renal impairment as a risk factor and regular NSAID co-administration as a protective factor against rash development during real-world GEM plus nab-PTX therapy for pancreatic cancer.