© 2004 European Society for Medical Oncology
Original Article |
Gemcitabine combined with oxaliplatin (GEMOX) in advanced biliary tract adenocarcinoma: a GERCOR study
1 Oncology Department and Digestive Surgery Department, Tenon Hospital, Paris; 2 Internal Medicine and Oncology Department, 3 Gastroenterology Department and 4 Digestive Surgery Department, Saint-Antoine Hospital, Paris; 5 Digestive Surgery Department, Pitié-Salpétrière Hospital, Paris; 6 Digestive Surgery Department, Institut Mutualiste Montsouris, Paris, France
* Correspondence to: Dr T. André, Service d'Oncologie Médicale, Hôpital Tenon, 4 rue de la Chine, 75970 Paris cedex 20, France. Tel: +33-1-56-01-60-21; Fax: +33-1-56-01-73-04; Email: thierry.andre{at}tnn.ap-hop-paris.fr
Background: Since gemcitabine–oxaliplatin (GEMOX) has been used in pancreatic adenocarcinoma, we studied its activity and tolerability in advanced biliary tract adenocarcinoma (ABTA).
Patients and methods: Consecutive adult patients with confirmed ABTA were recruited from four centers. Those in group A had performance status (PS) 0–2, bilirubin <2.5x normal and received GEMOX as first-line chemotherapy. Those in group B had PS >2 and/or bilirubin >2.5x normal and/or prior chemotherapy. All received gemcitabine 1000 mg/m2 as a 10 mg/m2/min infusion on day 1, followed by oxaliplatin 100 mg/m2 as a 2-h infusion on day 2, every 2 weeks.
Results: Tumor sites were gallbladder (19), extrahepatic bile ducts (5), ampulla of vater (3) and intrahepatic bile ducts (29). Results for group A (n=33) were: objective response 36% [95% confidence interval (CI) 18.7% to 52.3%], stable disease 26%, progressive disease 39%, median progression-free survival (PFS) 5.7 months and overall survival (OS) 15.4 months. Results for group B (n=23) were: objective response 22% (95% CI 6.5% to 37.4%), stable disease 30%, progressive disease 48%, PFS 3.9 months and OS 7.6 months. National Cancer Institute Common Toxicity Criteria grade 3–4 toxicities were neutropenia 14% of patients, thrombocytopenia 9%, nausea/vomiting 5% and peripheral neuropathy 7%.
Conclusion: The GEMOX combination is active and well tolerated in ABTA.
Key words: advanced biliary tract adenocarcinoma, chemotherapy, gemcitabine, oxaliplatin
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