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Background: MPACT study shoed survival benefit of nab-gem vs. gem in APC [Von Hoff D, NEJM 2013]. Sensory peripheral neuropathy is a dose-limiting toxicity associated ith nab. Neuromodulatory agents have shon limited activity in ameliorating neuropathy. OPTIMOX ;Stop and Go ; approach offers a reasonable strategy to reduce oxaliplatin-associated neuropathy in pts ith colorectal cancer CRC [ Tournigand C, JCO 2006]. Hoever no data exists to support an OPTIMOX-like strategy for nab in APC. We present here the first study that describes this approach in managing nab-related neuropathy. Methods: We conducted a retrospective study of pts treated ith nab-gem at our cancer center. We collected data by revieing medical records of those pts ho received nab-gem until development of grade 3 neuropathy, then continued gem alone as maintenance therapy; nab as reintroduced in these pts after progression radiological or increase in CA19-9 50 percent as long as neuropathy had resolved to lt grade 1. We named this ;Stop and Go ; approach as x0022;OPTINABx0022;. Primary end point as duration of disease control DDC . Results: A total of 27 pts M:F = 16:9; average age 63 years range: 53 71 received nab-gem from Jun 2013 Jan 2016. 7 pts 25 percent developed grade 3 neuropathy after an average of 4.2 months range: 3.0 5.0 . Nab as suspended; gem as continued as a maintenance therapy for an average of 2.8 months range: 2.0 4.0 . Upon progression of cancer radiologic in 5 and CA19-9 rise in 2 nab as added back to gem. 1 pt could not tolerate nab due to immediate orsening of neuropathy hile 6 pts continued nab-gem for an average of 2.2 months range: 1.0 4.0 . Reintroduction of nab resulted in improvement of DDC ith an average of 9.4 months range: 8.0 13.0 . Average overall survival for this group as 11.7 months range: 9.5 17.0 . After discontinuation of nab-gem, second-line therapy included FOLFIRI 2 , 5-FU 2 , TAS-102 1 and capecitabine 1 . Conclusions: This is the first study hich describes that OPTINAB strategy as feasible and improved DDC in pts ith APC. Although it is a small study, it supports need for a randomized prospective study to test concept of intensified, repeated short courses of nab.,J Clin Oncol 34, 2016 suppl; abstr e15672 ,Publication Only Gastrointestinal Noncolorectal Cancer