BACKGROUND: Gemcitabine-taxane combination chemotherapy has demonstrated a survival benefit in metastatic pancreatic cancer (PC). We present our experience with gemcitabine/docetaxel (gem/tax) based adjuvant treatment (Rx) following curative intent surgery.
 METHODS: All patients with upfront resectable PC from January 2010 to December 2015 were identified from our institutional database and tumor registry. We only included those who received gem/tax as initial Rx administered exclusively at our institution with or without chemoradiation (CRTx). Survival analysis was performed by Kaplan Meier methods and prognostic factors determined by Cox proportional hazard modeling.
 RESULTS: Of 185 eligible patients, 58 met study criteria. Median age of diagnosis was 65 years with 55% of patients undergoing an R1 resection (margin ≤1mm). Tumor characteristics included: median tumor size 28 mm, poor differentiation 54% and 67% lymph node positivity. The majority of patients (52/58) completed ≥80% of 24 week Rx. Of those patients, 71% received post gem/tax CRTx treatment. Grade 3/4 toxicity was observed in 52% of patients. Median disease-free survival (DFS) and overall survival (OS) were 35 months (95%CI: 20.7-NR) and 52 months (95%CI: 27.4-NR), respectively. Five year OS was 49% (95%CI: 33.7-63.4). On multivariate analysis (HR, 95%CI), margin status (4.55, 1.46-14.2, p=0.01), AJCC stage (10.9, 2.46-47.9, p=0.002) and CRTx (0.08, 0.03-0.24, p<0.000) were significant prognostic factors for OS while tumor size (2.59, 1.11-6.04, p=0.03), AJCC stage (3.29, 1.15-9.41, p=0.03), and CRTx (0.23, 0.09-0.56, p=0.001) were significant prognostic factors for DFS.
 CONCLUSIONS: In this select cohort of patients with resected PC, adjuvant gem/tax ± CRTx is feasible with favorable DFS and OS. Future prospective studies of gem/taxane-based adjuvant Rx in PC are warranted.

Gemcitabine/taxane adjuvant therapy in resected pancreatic cancer: A novel strategy for improved survival?