Letter to the Editor Re: Ahn DH, Krishna K, Blazer M, et al. “A modified regimen of biweekly gemcitabine and nab-paclitaxel in patients with metastatic pancreatic cancer is both tolerable and effective: a retrospective analysis.” Ther Adv Med Oncol https://doi.org/10.1177/1758834016676011

We read with interest the article on a recent retrospective analysis from The Ohio State University, which reported that a modified regimen of nab-paclitaxel plus gemcitabine (biweekly [q2w]) in patients with metastatic pancreatic cancer was associated with an acceptable toxicity profile and appeared to be relatively effective.1 We would like to point out caveats that must be considered before comparing the retrospective, single-institution chart review study in the United States (N = 79) with the global MPACT trial (N = 831; conducted at 151 centers), in which patients received nab-paclitaxel plus gemcitabine weekly for the first 3 of 4 weeks (qw 3/4).2 These caveats include, but are not limited to, the retrospective nature of the analysis (versus the prospective phase III MPACT trial), differences in methodology (e.g. patients seen every 2 weeks versus every week in MPACT), the lack of requirement for informed consent (requirement in both MPACT and our phase I/II study), differences in the rigor and completeness of the screening evaluation for inclusion in the study, and differences in patient populations (Table 1) and supportive care.1–3 Additionally, our prospective phase I/II study,3 conducted at four US centers (n = 67), should also be considered when interpreting efficacy and safety results of the relatively small retrospective analysis from The Ohio State University (Table 2)