A clinical retrospective study of anlotinib in combination with gemcitabine and albumin-bound paclitaxel for the first-line treatment of advanced pancreatic cancer

Anlotinib has demonstrated efficacy and tolerability in treating various tumors. The purpose of this retrospective study is to assess the efficacy and safety of anlotinib combined with gemcitabine and albumin-bound paclitaxel as a first-line treatment for advanced pancreatic cancer. Patients with advanced pancreatic cancer who are not candidates for surgery were divided into two groups: anlotinib plus gemcitabine/nab-paclitaxel (A + AG) (n = 32) and gemcitabine/nab-paclitaxel alone (AG) (n = 39). Data was analyzed for clinical characteristics, survival benefits, and side effects. The median progression-free survival (mPFS) (7.4 m vs 5.1 m, <i>p</i> = 0.003) and the median overall survival (mOS) (15 m vs 9.6 m, <i>p</i> = 0.001) were both prolonged in the A + AG group compared to AG group. The objective response rate (ORR) (12.5% vs 5.1%, <i>p</i> = 0.399) and the disease control rate (DCR) (87.5% vs 74.4%, <i>p</i> = 0.233) only disclosed increasing trends in the A + AG group compared to the AG group. Univariate analysis identified that pathology type (<i>p</i> = 0.002) affects PFS, while pathology type (<i>p</i> = 0.003), and CA199 level (<i>p</i> = 0.020) affect OS in the AG groups. In the A + AG group, the Thymidine kinase (TR) level affected PFS (<i>p</i> = 0.014) and OS (<i>p</i> = 0.035). Multivariate analysis showed no clinical factors correlated with PFS and OS in both the A + AG and AG groups. The most common adverse effects were leukopenia (91.5%), fatigue/poor appetite (85.9%), nausea/vomiting (80.3%), and thrombocytopenia (77.5%). The incidence of grade III/IV adverse reactions was similar in both groups. No grade V adverse reactions occurred. This study demonstrates that anlotinib combined with the AG chemotherapy regimen provides a new first-line therapeutic choice for patients with advanced pancreatic cancer.