Annals of Oncology 14:205-208, 2003
© 2003 European Society for Medical Oncology
Original Paper |
Weekly gemcitabine and cisplatin chemotherapy: a well-tolerated but ineffective chemotherapeutic regimen in advanced pancreatic cancer patients. A report from the Italian Group for the Study of Digestive Tract Cancer (GISCAD)
Departments and Units of Medical Oncology, Parma, Bergamo, Pesaro, Treviglio (BG), Milan, Taormina (ME) and Urbino (PU), Italy
Received 13 May 2002; revised 5 August 2002; accepted 9 September 2002
Background:
This phase II study was initiated to determine the activity and toxicity of a combination of gemcitabine (GEM) and cisplatin (CDDP) in patients with pancreatic cancer.
Patients and methods:
CDDP 35 mg/m2 was given as a 30-min infusion and GEM 1000 mg/m2 as a 30-min infusion. Both drugs were administered once weekly for 2 consecutive weeks out of every 3 weeks to chemonaive patients with locally advanced or metastatic pancreatic cancer.
Results:
Forty-five advanced pancreatic cancer patients received this regimen for a total of 180 cycles of chemotherapy. One complete and four partial responses have been observed for an overall response rate of 9% (95% confidence interval 10% to 11%). Twenty-one patients (46%) had stable disease and 19 progressed on therapy. The median time to progression was 3.6 months, with a median survival of 5.6 months. A clinical benefit was obtained in nine of 37 patients (24%). Side-effects were mainly represented by hematological toxicity. Grade 3/4 WHO toxicities included neutropenia (6% of the patients) and thrombocytopenia (11%). The dose of GEM and CDDP was reduced in 14 patients (31%) and treatment was delayed in 10 patients (22%).
Conclusions:
Our results in terms of response rate, clinical benefit and survival do not support an advantage for the combination of GEM and CDDP given by this schedule.
Key words: intensive chemotherapy, palliation, pancreatic cancer
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