# Gemcitabine + nab-paclitaxel

Source: https://onco.cc/drugs/gemcitabine-nab-paclitaxel/  
OnCo record `gemcitabine-nab-paclitaxel` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Gemcitabine plus nab-paclitaxel is the gentler of the two standard chemotherapy backbones for pancreatic cancer, and the base on which most new drugs are being tested.

## Summary

MPACT (2013): OS 8.5 vs 6.7 months versus gemcitabine alone. Preferred for less fit patients; the control or backbone arm in PANOVA-3 (TTFields), zoldonrasib first-line combinations, and CLDN18.2 and other add-on trials. Gemcitabine monotherapy (1997) was the standard for 14 years before FOLFIRINOX.

## Fields

- Kind: Treatment
- Status: standard-of-care
- Last checked: 2026-09-06
- Brand: Gemzar + Abraxane
- Modality: Cytotoxic regimen
- Mechanism: Nucleoside analogue (gemcitabine) plus albumin-bound taxane that may deplete stroma and increase gemcitabine delivery.
- Approvals: US 2013: First-line metastatic pancreatic adenocarcinoma (nab-paclitaxel label)

## Notes

- Pancreatic cancer, UK status: NICE TA476 (6 September 2017) recommends the combination for untreated metastatic disease only if other combination chemotherapies are unsuitable and the person would otherwise have gemcitabine alone; NICE NG85 1.9.5 repeats this. Adjuvant use missed its primary endpoint in APACT and is not recommended by NICE or NCCN. It is the control arm of PANOVA-3, NAPOLI 3, CanStem111P (median 11.7 months), HALO-301, RESOLVE and RASolute 303.

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Gemcitabine
- Wikipedia: https://en.wikipedia.org/wiki/Gemcitabine
- NICE TA476 (6 September 2017): https://www.nice.org.uk/guidance/ta476

## Connected records

- cancers: [Adenosquamous carcinoma of the pancreas](https://onco.cc/cancers/pancreatic-adenosquamous-carcinoma/), [Ampullary cancer (ampulla of Vater)](https://onco.cc/cancers/ampullary/), [Borderline resectable pancreatic ductal adenocarcinoma](https://onco.cc/cancers/borderline-resectable-pdac/), [BRCA or PALB2-mutant pancreatic ductal adenocarcinoma](https://onco.cc/cancers/brca-palb2-pdac/), [Colloid (mucinous non-cystic) carcinoma of the pancreas](https://onco.cc/cancers/pancreatic-colloid-carcinoma/), [Invasive carcinoma arising in an intraductal papillary mucinous neoplasm (IPMN-associated carcinoma)](https://onco.cc/cancers/ipmn-associated-carcinoma/), [KRAS G12C-mutant pancreatic ductal adenocarcinoma](https://onco.cc/cancers/kras-g12c-pdac/), [KRAS wild-type pancreatic ductal adenocarcinoma](https://onco.cc/cancers/kras-wild-type-pdac/), [Locally advanced unresectable pancreatic ductal adenocarcinoma](https://onco.cc/cancers/locally-advanced-pdac/), [Metastatic pancreatic ductal adenocarcinoma](https://onco.cc/cancers/metastatic-pdac/), [Mismatch repair deficient (MSI-high) pancreatic ductal adenocarcinoma](https://onco.cc/cancers/msi-high-pdac/), [Mucinous cystic neoplasm of the pancreas with associated invasive carcinoma (MCN-associated carcinoma)](https://onco.cc/cancers/mcn-associated-carcinoma/), [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/), [Resectable pancreatic ductal adenocarcinoma](https://onco.cc/cancers/resectable-pdac/), [Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells](https://onco.cc/cancers/pancreatic-undifferentiated-carcinoma-ogc/)
- technologies: [Cytotoxic chemotherapy](https://onco.cc/technologies/cytotoxic-chemotherapy/)
- drugs: [Paclitaxel / nab-paclitaxel](https://onco.cc/drugs/paclitaxel/)
- trials: [24BRO681 : Alternating Gnp and mFOLFIRINOX for BR-PDAC](https://onco.cc/trials/nct07043270/), [A Phase III, Randomized, Clinical Trial of GnP Combined With SBRT and Serplulimab Versus GnP as First-Line Treatment for Patients With Recurrent or Metastatic P](https://onco.cc/trials/nct07336953/), [A Single-center, Prospective, Two Cohort Study of Surufatinib Combined With AG or AG in the First-line Treatment of Locally Advanced or Metastatic Pancreatic Ca](https://onco.cc/trials/nct05969171/), [Actuate 1801 Part 3B (elraglusib)](https://onco.cc/trials/actuate-1801/), [AG Plus Nimotuzumab Sequential Irreversible Electroporation Ablation for Locally Advanced Pancreatic Cancer](https://onco.cc/trials/nct06938503/), [Anlotinib Plus Benmelstobart and AG in First-line Treatment of Advanced Metastatic Pancreatic Cancer (ALTER-PA-001)](https://onco.cc/trials/nct06621095/), [APACT](https://onco.cc/trials/apact/), [CanStem111P](https://onco.cc/trials/canstem111p/), [Firstline Sequential AG and mFOLFOX Combined With Serplulimab and Bevacizumab Versus AG Chemotherapy Alone in Advanced Pancreatic Cancer](https://onco.cc/trials/nct07235930/), [HALO 109-301](https://onco.cc/trials/halo-301/), [HRS-4642 With Nimotuzumab and Chemotherapy for First-line Treatment of Advanced Pancreatic Cancer Patients](https://onco.cc/trials/nct06770452/), [LAPIS](https://onco.cc/trials/lapis-trial/), [LDRT Combined With Pucotenlimab and Standard Therapy for Advanced Pancreatic Cancer: A Single-Arm Study](https://onco.cc/trials/nct07312422/), [MPACT](https://onco.cc/trials/mpact/), [NAPOLI 3](https://onco.cc/trials/napoli-3/), [Neoadjuvant Chemotherapy for Pancreatic Cancer Followed by GS and GnP](https://onco.cc/trials/nct05268692/), [NEOLAP](https://onco.cc/trials/neolap/), [NEONAX](https://onco.cc/trials/neonax/), [Nimotuzumab Combined With Nab-paclitaxel/Gemcitabine in the Perioperative Treatment of High-risk Resectable/Borderline Resectable Pancreatic Cancer](https://onco.cc/trials/nct07277452/), [PANOVA-3](https://onco.cc/trials/panova-3/), [PRIMUS 001](https://onco.cc/trials/primus-001/), [QL1706+Lenvatinib+AG Regimen as First-line Treatment for Advanced Metastatic Pancreatic Cancer](https://onco.cc/trials/nct07110064/), [RESOLVE](https://onco.cc/trials/resolve/), [Saltikva for Metastatic Pancreatic Cancer](https://onco.cc/trials/nct04589234/), [SBRT Followed by Ipilimumab N01, Sintilimab, Nab-Paclitaxel and Gemcitabine for Locally Advanced Pancreatic Cancer](https://onco.cc/trials/nct07683221/), [SCALOP-2](https://onco.cc/trials/scalop-2/), [STARPAC2](https://onco.cc/trials/starpac2/), [Study to Assess the Safety, Tolerability of JPI-547 in Combination With Modified FOLFIRINOX or Gemcitabine-nab-paclitaxel in Patients With Locally Adv](https://onco.cc/trials/nct05257993/), [Surufatinib in Combination With Iparomlimab and Tuvonralimab Injection and AG Chemotherapy for Neoadjuvant Therapy of HRPC or BRPC](https://onco.cc/trials/nct07833241/), [Surufatinib Plus Camrelizumab and AS in First Line Treatment of Advanced Metastatic Pancreatic Cancer](https://onco.cc/trials/nct05218889/), [Surufatinib Plus Gemcitabine and Nab-paclitaxel vs. Gemcitabine Plus Nab-paclitaxel in Neoadjuvant Therapy for High - Risk Resectable or Borderline Resectable P](https://onco.cc/trials/nct07436741/), [SWOG S1505](https://onco.cc/trials/swog-s1505/), [TRYbeCA-1](https://onco.cc/trials/trybeca-1/)
- terms: [Classical versus basal-like (squamous) subtypes of pancreatic cancer, and GATA6](https://onco.cc/terms/classical-vs-basal-like/), [Living with FOLFIRINOX, NALIRIFOX and gemcitabine with nab-paclitaxel](https://onco.cc/terms/chemotherapy-side-effects-pancreatic/), [Pancreatic cancer drugs in England: NICE appraisals and the Cancer Drugs Fund (September 2026)](https://onco.cc/terms/pancreatic-cancer-uk-drug-access/)
- key papers: [Metastatic Pancreatic Cancer: ASCO Guideline Update](https://onco.cc/key-papers/paper-asco-metastatic-pancreatic-cancer-guideline-update-jco-2020/), [MPACT (Von Hoff 2013): nab-paclitaxel plus gemcitabine for metastatic pancreatic cancer](https://onco.cc/key-papers/paper-mpact-nab-paclitaxel-gemcitabine-nejm-2013/), [Randomized Phase III Trial of Pegvorhyaluronidase Alfa With Nab-Paclitaxel Plus Gemcitabine for Patients With Hyaluronan-High Metastatic Pancreatic Adenocarcinoma](https://onco.cc/key-papers/paper-halo-301-pegvorhyaluronidase-jco-2020/), [Tumor Treating Fields With Gemcitabine and Nab-Paclitaxel for Locally Advanced Pancreatic Adenocarcinoma: Randomized, Open-Label, Pivotal Phase III PANOVA-3 Study](https://onco.cc/key-papers/paper-panova-3-ttfields-locally-advanced-pancreatic-jco-2025/)
- roadmaps: [Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question](https://onco.cc/roadmaps/pancreatic-roadmap/)
- ideas: [Embed cachexia treatment in chemotherapy trials: weight, muscle and treatment delivery as co-primary endpoints](https://onco.cc/ideas/idea-pdac-cachexia-trials-embedded-in-chemotherapy-trials/), [RAS inhibitor combinations and sequence: pan-RAS plus G12D-selective, plus chemotherapy, and what to give after progression](https://onco.cc/ideas/idea-pdac-ras-inhibitor-combinations-and-sequencing/)

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