# MPACT

Source: https://onco.cc/trials/mpact/  
OnCo record `mpact` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

MPACT established the second modern first-line regimen for advanced pancreatic cancer: adding albumin-bound paclitaxel to gemcitabine lengthened median survival from 6.7 to 8.5 months and doubled two-year survival, with more neuropathy and neutropenia; it is the option for people not fit enough for FOLFIRINOX and the control arm of most trials since.

## Summary

MPACT randomised 861 patients (431 to nab-paclitaxel plus gemcitabine, 430 to gemcitabine) between 2009 and 2012. Median overall survival was 8.5 against 6.7 months (hazard ratio 0.72, 95 percent confidence interval 0.62 to 0.83; p below 0.001), one-year survival 35 against 22 percent and two-year survival 9 against 4 percent; median progression-free survival 5.5 against 3.7 months (hazard ratio 0.69) and independently reviewed response 23 against 7 percent. Grade 3 or worse neutropenia was 38 against 27 percent, fatigue 17 against 7 percent and peripheral neuropathy 17 against 1 percent, the neuropathy improving to grade 1 or less in a median 29 days after interruption; febrile neutropenia 3 against 1 percent. The long-term update (JNCI 2015) gave 8.7 against 6.6 months with 4 percent of the combination arm alive beyond three years and none on gemcitabine, and found high CA 19-9 and neutrophil-to-lymphocyte ratio prognostic. The FDA approved the combination in September 2013 and the EMA the same year (Abraxane product information); in England NICE TA476 (2017) restricts it to people for whom other combination chemotherapies are unsuitable and who would otherwise have gemcitabine alone. No UK sites took part.

## Fields

- Kind: Trial
- Status: positive
- Last checked: 2026-09-24
- Also known as: CA046; Metastatic Pancreatic Adenocarcinoma Clinical Trial
- Registry id: NCT00844649
- Phase: 3
- Setting: Untreated metastatic pancreatic adenocarcinoma with Karnofsky performance status 70 or more at 151 sites in 11 countries: nab-paclitaxel 125 mg/m2 followed by gemcitabine on days 1, 8 and 15 of 28 against gemcitabine alone, with overall survival as the primary endpoint
- Sponsor: Celgene (Bristol Myers Squibb)
- Enrolled: 861
- Result: Median overall survival 8.5 months with nab-paclitaxel plus gemcitabine against 6.7 months with gemcitabine (hazard ratio 0.72, 95 percent confidence interval 0.62 to 0.83; p below 0.001); progression-free survival 5.5 against 3.7 months; response 23 against 7 percent.
- Outcomes: Overall survival: Nab-paclitaxel + gemcitabine 8.5 months vs Gemcitabine 6.7 months, HR 0.72; Progression-free survival (independent review): Nab-paclitaxel + gemcitabine 5.5 months vs Gemcitabine 3.7 months, HR 0.69; Grade 3 or worse peripheral neuropathy: Nab-paclitaxel + gemcitabine 17% vs Gemcitabine 1%

## Sources

- ClinicalTrials.gov NCT00844649: https://clinicaltrials.gov/study/NCT00844649
- Von Hoff et al., increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine (NEJM 2013): https://doi.org/10.1056/NEJMoa1304369
- Goldstein et al., MPACT long-term survival (JNCI 2015): https://doi.org/10.1093/jnci/dju413
- Abraxane label (openFDA): adenocarcinoma of the pancreas study section: https://api.fda.gov/drug/label.json?search=openfda.brand_name:%22ABRAXANE%22

## Connected records

- cancers: [Metastatic pancreatic ductal adenocarcinoma](https://onco.cc/cancers/metastatic-pdac/), [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/)
- technologies: [Cytotoxic chemotherapy](https://onco.cc/technologies/cytotoxic-chemotherapy/)
- drugs: [Gemcitabine](https://onco.cc/drugs/gemcitabine/), [Gemcitabine + nab-paclitaxel](https://onco.cc/drugs/gemcitabine-nab-paclitaxel/), [Nab-paclitaxel](https://onco.cc/drugs/nab-paclitaxel/)
- companies: [Bristol Myers Squibb](https://onco.cc/companies/bms/)
- terms: [CA 19-9](https://onco.cc/terms/ca19-9/), [Neutropenia](https://onco.cc/terms/neutropenia/), [Peripheral neuropathy (chemotherapy-induced)](https://onco.cc/terms/peripheral-neuropathy/)
- people: [Daniel D. Von Hoff](https://onco.cc/people/daniel-von-hoff/)
- trials: [NAPOLI 3](https://onco.cc/trials/napoli-3/), [PANOVA-3](https://onco.cc/trials/panova-3/), [Study of Daraxonrasib and Daraxonrasib + GnP as First-line Treatment in Patients With Metastatic Pancreatic Adenocarcinoma](https://onco.cc/trials/nct07491445/)

---
JSON: https://onco.cc/api/v1/entities/mpact.json