Factors associated with peripheral neuropathy development during gemcitabine plus albumin-bound paclitaxel therapy as first-line treatment for unresectable pancreatic cancer: a retrospective evaluation

Gemcitabine plus albumin-bound paclitaxel is widely used as first-line therapy for unresectable pancreatic cancer, but it is frequently complicated by chemotherapy-induced peripheral neuropathy, which may lead to functional impairment and treatment modification. Factors associated with clinically relevant neuropathy, defined as grade 2 or higher, remain insufficiently clarified. This study aimed to identify factors associated with the development of grade ≥ 2 neuropathy during therapy. We conducted a retrospective observational study using medical records of patients with unresectable pancreatic cancer who received this combination therapy at Rakuwakai Otowa Hospital from April 2015 to March 2024. Patient characteristics, treatment details, and neuropathy outcomes were collected. Univariate and multivariate logistic regression analyses were performed to evaluate factors associated with grade ≥ 2 neuropathy. Statistical significance was defined as P < 0.05. Fifty-seven patients were included in the analysis, and 19 patients (33.3%) developed grade ≥ 2 neuropathy. In multivariate logistic regression, a history of diabetes mellitus was significantly associated with the development of grade ≥ 2 neuropathy (odds ratio 3.89, 95% confidence interval 1.06–14.3, P = 0.041). No other clinical or treatment-related variables demonstrated significant associations. A history of diabetes mellitus may be associated with the development of grade ≥ 2 CIPN in patients with unresectable pancreatic cancer undergoing GnP therapy. Healthcare professionals should detect CIPN symptoms early and manage them appropriately, particularly in patients with diabetes mellitus.