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Annals of Oncology 14:1100-1105, 2003
© 2003 European Society for Medical Oncology

Original Paper

A phase II study of mitomycin C, cisplatin and protracted infusional 5-fluorouracil in advanced pancreatic carcinoma: efficacy and low toxicity

R. D. Petty1,4,+, M. C. Nicolson1, S. Skaria1, T. S. Sinclair2, L. M. Samuel1 and M. Koruth3

Departments of 1 Oncology (ANCHOR Unit), 2 Gastroenterology and 3 Surgery, Aberdeen Royal Infirmary, Aberdeen; 4 Department of Medicine and Therapeutics (Oncology), University of Aberdeen, Institute of Medical Sciences, Foresterhill, Aberdeen, UK

Received 8 January 2003; accepted 5 March 2003

Background:

The effective treatment of unresectable pancreatic carcinoma represents a formidable challenge. There is a need to develop systemic therapies which combine efficacy with acceptable toxicity. The current ‘gold standard’ gemcitabine gives an objective response rate of the order of 20% and median survival up to 6 months. Here we have evaluated the efficacy and toxicity of mitomycin C, cisplatin and protracted infusional 5-fluorouracil (MCF).

Patients and methods:

Forty-five patients with locally advanced (13 patients) or metastatic (32 patients) pancreatic carcinoma were treated with mitomycin C 7 mg/m2 6 weekly, cisplatin 60 mg/m2 3 weekly and protracted venous infusion 5-FU 300 mg/m2/day. Patients were evaluated for response after three cycles and received six cycles in total in the absence of progressive disease or poor tolerance. Median age was 62 (45–75) years; 41 patients were World Health Organization performance status 0–1.

Results:

Treatment was well tolerated with 36 (84%) patients completing three or more cycles. Grade 3 or 4 toxicities were uncommon: anaemia in three patients (7%), mucositis in two (5%), nausea and vomiting in three (7%) and diarrhoea in one (1%). An objective response was seen in 21 (46%) patients. There was one complete response. The median survival overall was 7.1 months and 10.5 months in responders. The median duration of response was 4.3 months. One-year survival was 29%, 2-year survival was 18%.

Conclusions:

MCF combines efficacy with low toxicity in the treatment of advanced pancreatic carcinoma. The efficacy is at least comparable and may be superior to single-agent gemcitabine and MCF may therefore provide a cost-effective alternative.

Key words: chemotherapy, cisplatin, 5-fluorouracil, mitomycin C, pancreatic cancer


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