***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Purpose The primary objective of this study was to evaluate the dose-limiting toxicities ( DLTs ) and identify the maximum-tolerated dose ( MTD ) and recommended dose of nab-paclitaxel plus gemcitabine as a first-line treatment in Chinese patients with advanced pancreatic ductal adenocarcinoma ( PDA ) . Methods Patients with previously untreated advanced PDA were treated with nab-paclitaxel followed by gemcitabine ( 1,000 mg/m2 ) administered intravenously for 30 min on days 1 and 8 and repeated every 21 days . Results Patients received nab-paclitaxel at the following dose levels : 80 mg/m2 ( n = 3 ) , 100 mg/m2 ( n = 6 ) , and 120 mg/m2 ( n = 12 ) . The DLTs evaluated were elevated alanine aminotransferase and febrile neutropenia . However , there had no two out of three to six patients experienced DLTs , the MTD was not met . A total of 93 cycles were administered . The most common grade 3/4 toxicities were neutropenia ( 9.52 % ) , thrombocytopenia ( 4.76 % ) , and sensory neuropathy ( 4.76 % ) . For 12 patients receiving 120 mg/m2 , the overall response rate and disease control rate were 41.67 and 83.33 % , respectively , and the median progression-free survival and overall survival were 5.23 and 12.17 months , respectively . Conclusions Treatment with albumin-bound nab-paclitaxel ( 120 mg/m2 ) plus gemcitabine has a favorable safety profile with an encouraging antitumor effect in Chinese patients BACKGROUND Pancreas adenocarcinoma is the sixth cause of cancer-related death worldwide with an increasing mortality in the Western countries . Recently , the association between nab-paclitaxel ( nab-P ) and gemcitabine ( GEM ) has significantly improved progression-free and overall survival . PATIENTS AND METHODS Patients affected by metastatic pancreas adenocarcinoma were treated at the Department of Abdominal Oncology of the National Cancer Institute of Naples from July 2015 to July 2016 with nab-P at 125 mg per square meter of body-surface area followed by GEM at 1,000 mg per square meter on days 1 , 8 and 15 every 4 weeks . Computed tomography ( CT ) was performed every three months of therapy . Toxicity was grade d with National Cancer Institute-Common Toxicity Criteria ( NCI-CTC ) v4.0 . Objective responses were evaluated with Response Evaluation Criteria in Solid Tumors ( RECIST ) . Analysis of time-to-progression is only descriptive . Pain was evaluated with a visual analogue scale ( VAS ) . RESULTS Twenty-three patients were treated . Median age was 67 years ( range=45 - 81 ) ; 8 patients were ≥70 years old . Performance status ( PS ) Eastern Cooperative Oncology Group ( ECOG ) was 2 in 8 patients , 1 in 10 and 0 in 5 . Twelve patients presented with diffuse hepatic metastases , 4 with carcinosis , 7 with more than one organ involvement . Nab-P was reduced at 100 mg per square meter in all patients . The most common G3/G4 adverse events were neutropenia ( 13.0 % G4 , 8.6 % G3 ; none was febrile ) , neuropathy ( 30.4 % G3 ) and asthenia ( G3 17.3 % ) . The disease control rate was 43.4 % ( partial response+stable disease ( PR+SD ) 10/23 ) . The median time-to-progression was 7.9 months ( 95 % confidence interval (CI)=5.8 - 11.2 ) . After three months of therapy the PS improved in 14 patients , as well as pain in 18 patients . CONCLUSION We present an experience with nab-P and GEM association in a series with poor PS and highly metastatic disease relatively to a previous r and omized study . The schedule is feasible , with nab-P at 100 mg per square meter achieving a good disease control rate , as well as a clinical benefit Background The LAP07 r and omized trial calls into question the role of radiation therapy ( RT ) in the modern treatment of locally advanced pancreatic cancer ( LAPC ) . However , advances in chemotherapy and RT limit application of the LAP07 results to current clinical practice . Here we utilize the National Cancer Data base ( NCDB ) to evaluate the effects of RT in patients receiving chemotherapy for LAPC . Methods Using the NCDB , patients with American Joint Committee on Cancer ( AJCC ) clinical stage T2–4 , N0–1 , M0 adenocarcinoma of the pancreas from 2004 to 2014 were analyzed . Patients were stratified into chemotherapy only ( CT ) and chemoradiation ( CRT ) cohorts . Patients undergoing definitive RT  , defined as at least 20 fractions or ≥ 5 Gy per fraction [ i.e. , stereotactic body radiation therapy ( SBRT ) ] were included in the CRT cohort . Propensity-score matching ( PSM ) and l and mark analysis were used to address selection bias and lead-time bias , respectively . Results 13,004 patients met inclusion criteria , of whom 7034 ( 54 % ) received CT and 5970 ( 46 % ) received CRT . After PSM , 5215 patients remained in each cohort . The CRT cohort demonstrated better overall survival ( OS ) compared with CT alone , with median and 1-year OS of 12 versus 10 months , and 50 % and 41 % , respectively ( p < 0.001 ) . On multivariable analysis , CRT was associated with superior OS with hazard ratio of 0.79 ( 95 % confidence interval 0.76–0.83 ) compared with CT alone . Conclusions In our series , addition of definitive radiotherapy to CT was associated with better OS when compared with CT alone in LAPC . Definitive radiotherapy should remain a treatment option for LAPC , but optimal selection criteria remain unclear Purpose For unresectable locally advanced ( UR-LA ) pancreatic cancer , chemoradiotherapy has been recommended by the NCCN guidelines . We design ed a chemoradiotherapy protocol using nab-paclitaxel combined with gemcitabine ( GnP ) for patients with UR-LA pancreatic cancer . The purpose of this phase I study was to determine a recommended dose ( RD ) for this novel regimen . Methods Patients with UR-LA pancreatic cancer were eligible . The frequency of dose-limiting toxicities ( DLTs ) was evaluated , and the RD was determined . Patients were classified according to the design ated dose levels of chemoradiotherapy using the GnP regimen . After additional 6 cycles of the GnP regimen were administered , surgery was considered if the patients had stable disease and tumor marker levels had normalized . Results DLT ( grade 4 thrombocytopenia ) was observed only in 1 of 12 patients , and the RD was set at level 3 . Grade 3–4 leukopenia was observed in 9 ( 75.0 % ) patients , and neutropenia in 7 ( 58.3 % ) . The response rate was 41.7 % , and the disease control rate was 100 % . Conversion surgery was performed in 6 ( 50 % ) patients , and curative resection ( R0 ) was performed in all 6 patients ( 100 % ) . Stratification according to the Evans classification system demonstrated one patient with grade 1b , one with grade 2 , two with grade 3 , and two with grade 4 disease . Conclusion The RD for weekly administration was 800 mg/m2 for gemcitabine and 100 mg/m2 for nab-paclitaxel with a 50.4 Gy radiation . The GnP regimen at this dosage was promising with 6 of 12 patients proceeding to conversion surgery , and should be evaluated further in a phase II trial BACKGROUND In a phase 1 - 2 trial of albumin-bound paclitaxel ( nab-paclitaxel ) plus gemcitabine , substantial clinical activity was noted in patients with advanced pancreatic cancer . We conducted a phase 3 study of the efficacy and safety of the combination versus gemcitabine monotherapy in patients with metastatic pancreatic cancer . METHODS We r and omly assigned patients with a Karnofsky performance-status score of 70 or more ( on a scale from 0 to 100 , with higher scores indicating better performance status ) to nab-paclitaxel ( 125 mg per square meter of body-surface area ) followed by gemcitabine  ( 1000 mg per square meter ) on days 1 , 8 , and 15 every 4 weeks or gemcitabine monotherapy ( 1000 mg per square meter ) weekly for 7 of 8 weeks ( cycle 1 ) and then on days 1 , 8 , and 15 every 4 weeks ( cycle 2 and subsequent cycles ) . Patients received the study treatment until disease progression . The primary end point was overall survival ; secondary end points were progression-free survival and overall response rate . RESULTS A total of 861 patients were r and omly assigned to nab-paclitaxel plus gemcitabine ( 431 patients ) or gemcitabine  ( 430 ) . The median overall survival was 8.5 months in the nab-paclitaxel-gemcitabine group as compared with 6.7 months in the gemcitabine group ( hazard ratio for death , 0.72 ; 95 % confidence interval [ CI ] , 0.62 to 0.83 ; P<0.001 ) . The survival rate was 35 % in the nab-paclitaxel-gemcitabine group versus 22 % in the gemcitabine group at 1 year , and 9 % versus 4 % at 2 years . The median progression-free survival was 5.5 months in the nab-paclitaxel-gemcitabine group , as compared with 3.7 months in the gemcitabine group ( hazard ratio for disease progression or death , 0.69 ; 95 % CI , 0.58 to 0.82 ; P<0.001 ) ; the response rate according to independent review was 23 % versus 7 % in the two groups ( P<0.001 ) . The most common adverse events of grade 3 or higher were neutropenia ( 38 % in the nab-paclitaxel-gemcitabine group vs. 27 % in the gemcitabine group ) , fatigue ( 17 % vs. 7 % ) , and neuropathy ( 17 % vs. 1 % ) . Febrile neutropenia occurred in 3 % versus 1 % of the patients in the two groups . In the nab-paclitaxel-gemcitabine group , neuropathy of grade 3 or higher improved to grade 1 or lower in a median of 29 days . CONCLUSIONS In patients with metastatic pancreatic adenocarcinoma , nab-paclitaxel plus gemcitabine significantly improved overall survival , progression-free survival , and response rate , but rates of peripheral neuropathy and myelosuppression were increased . ( Funded by Celgene ; Clinical Trials.gov number , NCT00844649 . ) PURPOSE To provide evidence -based recommendations to oncologists and others for treatment of patients with locally advanced , unresectable pancreatic cancer . METHODS American Society of Clinical Oncology convened an Expert Panel of medical oncology , radiation oncology , surgical oncology , gastroenterology , palliative care , and advocacy experts and conducted a systematic review of the literature from January 2002 to June 2015 . Outcomes included overall survival , disease-free survival , progression-free survival , and adverse events . RESULTS Twenty-six r and omized controlled trials met the systematic review criteria . RECOMMENDATIONS A multiphase computed tomography scan of the chest , abdomen , and pelvis should be performed . Baseline performance status and comorbidity profile should be evaluated . The goals of care , patient preferences , psychological status , support systems , and symptoms should guide decisions for treatments . A palliative care referral should occur at first visit . Initial systemic chemotherapy ( 6 months ) with a combination regimen is recommended for most patients ( for some patients radiation therapy may be offered up front ) with Eastern Cooperative Oncology Group performance status 0 or 1 and a favorable comorbidity profile . There is no clear evidence to support one regimen over another . The gemcitabine-based combinations and treatments recommended in the metastatic setting ( eg , fluorouracil , leucovorin , irinotecan , and oxaliplatin and gemcitabine plus nanoparticle albumin-bound paclitaxel ) have not been evaluated in r and omized controlled trials involving locally advanced , unresectable pancreatic cancer . If there is local disease progression after induction chemotherapy , without metastasis , then radiation therapy or stereotactic body radiotherapy may be offered also with an Eastern Cooperative Oncology Group performance status ≤ 2 and an adequate comorbidity profile . If there is stable disease after 6 months of induction chemotherapy but unacceptable toxicities , radiation therapy may be offered as an alternative . Patients with disease progression should be offered treatment per the ASCO Metastatic Pancreatic Cancer Treatment Guideline . Follow-up visits every 3 to 4 months are recommended . Additional information is available at www.asco.org/ guidelines /LAPC and www.asco.org/ guidelines /MetPC and www.as 
    Output:
    
NG has been proven to reduce tumours with an acceptable toxicity profile in metastatic pancreatic cancer .
This analysis further demonstrates the efficacy and safety of NG for treating LAPC