Abstract:Objective To investigate the efficacy and safety of traditional AG regimen [gemcitabine （1 000 mg/m, d1, d8） + albumin-bound paclitaxel（125 mg/m, d1, d8）, 21 days as a cycle] and other gemcitabine-based regimen [gemcitabine alone or combined with S-1（tegafur, gimeracil and oteracil potassium）/oxaliplatin/arotinib] in the treatment of advanced and metastatic pancreatic cancer. Methods From January 2017 to January 2022, 64 patients with advanced and metastatic pancreatic cancer were retrospectively collected from Sir Run Run Hospital of Nanjing Medical University. There were 33 patients received traditional AG therapy and 31 patients received chemotherapy mainly with gemcitabine. Survival analysis was conducted based on follow-up data, with the study endpoints being overall survival (OS） and progression free survival （PFS）, and the secondary study endpoint being the incidence of grade 3/4 adverse reactions. Results The median OS of the AG regimen group and the gemcitabine group were 12.2 months and 7.9 months, respectively, and there was no significant difference between two groups （χ=1.517, P=0.218）. The median PFS of the AG regimen group and the gemcitabine group was 7.0 months and 3.3 months, respectively（χ=8.683, P=0.003）. There was no significant difference in the incidence of grade 3/4 adverse events between the two groups of patients（P＞0.05）. Conclusion The first-line treatment of albumin-bound paclitaxel combined with gemcitabine in patients with advanced pancreatic cancer has significant clinical effects, which significantly controls the disease progress and extends the PFS of patients.