Latest Cancer TreatmentsDr. Mohammadreza Dabiri
Dr. Mohammadreza Dabiriفارسی
Treatment regimen

Gemcitabine with nab-paclitaxel: dose and schedule

Days 1, 8 and 15 every 28 days; metastatic pancreatic cancer

Updated: 28 October 20261 min read1 reference

Summary for doctors

  • A first-line option for patients who are not suitable for FOLFIRINOX (ECOG 0 to 2) [1].
  • Low emetogenicity; neutropenia, fatigue and neuropathy are the main side effects [1].

Dose and schedule

Gem/nab-P

Metastatic pancreatic cancer, first lineCycle length: Every 28 days

Metastatic pancreatic cancer, first line

DrugDoseRouteSchedule
Nab-paclitaxel125 mg/m²IV over 30 to 40 minutesDays 1, 8 and 15
Gemcitabine1000 mg/m²IV over 30 minutes, after nab-paclitaxelDays 1, 8 and 15
Cycle length
Every 28 days
Duration
Until progression or toxicity

Doses as in the MPACT study [1]. In older patients, many centres use a day 1 and 15 every 28 days schedule.

Evidence: MPACT (2013)

Doses follow the trial protocol, guideline or official drug label (source given in the notes of each regimen). Before prescribing, check blood counts, renal and hepatic function, drug interactions and the patient’s condition, and adjust the dose according to the drug label.

Premedication and supportive care

  • Antiemetics: a single drug (dexamethasone or a 5-HT3 antagonist).
  • Nab-paclitaxel does not need anti-allergy premedication.

Monitoring and dose adjustment

  • Blood counts before each infusion (days 1, 8 and 15); with neutropenia or thrombocytopenia that day's dose is omitted or reduced.
  • Grade 3 neuropathy: hold nab-paclitaxel until recovery to grade 1 and continue at a lower dose [1].
  • Fever, dyspnoea or a new cough: rule out gemcitabine pneumonitis.

Main evidence

Show detailsHide

MPACT: adding nab-paclitaxel to gemcitabine increased median survival from 6.7 to 8.5 months; grade 3 neuropathy in 17% and grade 3 to 4 neutropenia in 38% [1].

Related cancer types

Pancreatic cancer

Treatment regimens (physicians)

FOLFIRINOX and mFOLFIRINOX: dose and side effectsGemcitabine-cisplatin with durvalumab in biliary tract cancer

Physician tools and lessons

Khorana Score (Cancer-Associated Thrombosis Risk)Germline genetic testing in cancer: who, and which genes?

References

1 reference
Show all references, 1 with a study cardClose the reference list

Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.

  1. 1
    Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabineVon Hoff DD, Ervin T, Arena FP, et al · N Engl J Med · 2013;369:1691-703
    Study cardDOIPubMed Back to text: 1 2 3 4 5

This page is based on reputable scientific sources and was last updated on 28 October 2026. The content of this website is for educational and informational purposes only and does not replace consultation, diagnosis or treatment by a specialist physician. Consult your treating physician about any treatment decision.

Printed from the website; the full and up-to-date version: https://drdabiri.com/en/regimens/gemcitabine-nab-paclitaxel/

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