Sezgin, Y.Karhan, O.Aldemir, M.N.Ürün, M.Erçek, B.M.Urakcı, Z.Ergün, Y.2025-05-102025-05-1020252045-232210.1038/s41598-025-96157-62-s2.0-105003097205https://doi.org/10.1038/s41598-025-96157-6Despite numerous studies on second-line therapies in metastatic pancreatic cancer, there is no randomized study evaluating the efficacy of gemcitabine plus nab-paclitaxel as a second-line treatment. This study aims to examine the efficacy of gemcitabine plus nab-paclitaxel in second-line therapy. In this retrospective study, a total of 218 patients from 23 centers were included. The primary endpoint was progression-free survival (PFS), secondary endpoints included overall survival (OS), treatment efficacy based on ECOG performance status (PS), and tumor marker (CEA, CA 19 − 9) levels. In the second-line treatment with gemcitabine plus nab-paclitaxel, the median PFS was 5.1 months (95% CI, 5.6 to 7.1), and the median OS was 8.6 months (95% CI, 7.3 to 10.0). Median PFS was 6.6 months in patients with normal CEA levels compared to 4.4 months in patients with high CEA levels (P = 0.01). Median PFS was 6 months in patients with ECOG PS 0–1 compared to 3.8 months in patients with PS 2 (P < 0.01). This study demonstrates the contribution of gemcitabine plus nab-paclitaxel in both OS and PFS in second-line treatment of metastatic pancreatic cancer. It was found to be a good option especially for young patients with good ECOG PS. © The Author(s) 2025.eninfo:eu-repo/semantics/closedAccessGemcitabine Plus Nab-PaclitaxelMetastatic Pancreatic CancerOverall SurvivalProgression-Free SurvivalArticle151Q2Q140188172WOS:001460349000023