Literature DB >> 16078261

Fixed dose-rate gemcitabine infusion as first-line treatment for advanced-stage carcinoma of the pancreas and biliary tree.

Alain Gelibter1, Paola Malaguti, Serena Di Cosimo, Emilio Bria, Enzo Maria Ruggeri, Paolo Carlini, Fabio Carboni, Giuseppe Maria Ettorre, Mario Pellicciotta, Diana Giannarelli, Edmondo Terzoli, Francesco Cognetti, Michele Milella.   

Abstract

BACKGROUND: Gemcitabine infusion at the fixed dose rate of 10 mg/m(2) per minute (FDR-gemcitabine) has pharmacokinetic advantages and may result in improved therapeutic efficacy.
METHODS: Between April 2002 and September 2003, 40 patients with advanced-stage pancreatic adenocarcinoma (PDAC; n = 27) or biliary tree carcinoma (BTC; n = 13) were treated with weekly FDR-gemcitabine (1000 mg/m(2)). The primary end point was the response rate. The secondary end points were progression-free and overall survival (PFS and OS), tumor marker response, and clinical benefit response (CBR).
RESULTS: The overall response rate (ORR) on an intent-to-treat basis was 15% (95% confidence interval [95% CI], 4-26%). A positive CBR was obtained in 14 of 29 (48%) patients. Seventeen of 25 (68%) patients had a reduction in carbohydrate antigen 19-9 (CA 19-9) of > 25%. The median time to treatment failure and the median PFS were 17 weeks (95% CI, 13-22 weeks) and 19 weeks (95% CI, 15-23 weeks), respectively. The median OS was 40 weeks (95% CI, 36-45 weeks) and the 1-year actuarial survival rate was 25.8%. Multivariate analysis showed that a performance status score of 0-1 at study entry and locally advanced disease were the only independent predictors of longer PFS and OS, whereas a reduction in CA 19-9 serum levels > 75% was an independent predictor of longer PFS, but had no impact on OS. Toxicity was mild with Grade 3-4 neutropenia (according to the National Cancer Institute-Common Toxicity Criteria [version 2.0]) in 18 of 427 treatment weeks (4.2%), and Grade 3 anemia and thrombocytopenia in 6 of 427 treatment weeks (1.4%) and 9 of 427 treatment weeks (2.1%), respectively, and asymptomatic Grade 3-4 transaminase elevation in 21 of 427 treatment weeks (4.9%).
CONCLUSIONS: FDR-gemcitabine at the weekly dose of 1000 mg/m(2) demonstrated promising activity, despite negligible toxicity, in patients with advanced-stage PDAC and BTC. Copyright 2005 American Cancer Society.

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Year:  2005        PMID: 16078261     DOI: 10.1002/cncr.21286

Source DB:  PubMed          Journal:  Cancer        ISSN: 0008-543X            Impact factor:   6.860


  10 in total

Review 1.  Developments in metastatic pancreatic cancer: is gemcitabine still the standard?

Authors:  Jie-Er Ying; Li-Ming Zhu; Bi-Xia Liu
Journal:  World J Gastroenterol       Date:  2012-02-28       Impact factor: 5.742

Review 2.  [Diagnostics and treatment of cholangiocellular carcinoma].

Authors:  L Zender; N P Malek
Journal:  Internist (Berl)       Date:  2016-12       Impact factor: 0.743

Review 3.  Metastatic pancreatic cancer: Is there a light at the end of the tunnel?

Authors:  Vanja Vaccaro; Isabella Sperduti; Sabrina Vari; Emilio Bria; Davide Melisi; Carlo Garufi; Carmen Nuzzo; Aldo Scarpa; Giampaolo Tortora; Francesco Cognetti; Michele Reni; Michele Milella
Journal:  World J Gastroenterol       Date:  2015-04-28       Impact factor: 5.742

4.  Fixed-dose-rate gemcitabine: a viable first-line treatment option for advanced pancreatic and biliary tract cancer.

Authors:  Michele Milella; Alain J Gelibter; Maria Simona Pino; Giandominik Bossone; Paolo Marolla; Isabella Sperduti; Francesco Cognetti
Journal:  Oncologist       Date:  2010

5.  First-line erlotinib and fixed dose-rate gemcitabine for advanced pancreatic cancer.

Authors:  Vanja Vaccaro; Emilio Bria; Isabella Sperduti; Alain Gelibter; Luca Moscetti; Giovanni Mansueto; Enzo Maria Ruggeri; Teresa Gamucci; Francesco Cognetti; Michele Milella
Journal:  World J Gastroenterol       Date:  2013-07-28       Impact factor: 5.742

Review 6.  Current and Future Therapies for Pancreatic Ductal Adenocarcinoma.

Authors:  Áine Sally; Ryan McGowan; Karen Finn; Brian Michael Moran
Journal:  Cancers (Basel)       Date:  2022-05-13       Impact factor: 6.575

7.  Complete response in gallbladder cancer to erlotinib plus gemcitabine does not require mutation of the epidermal growth factor receptor gene: a case report.

Authors:  Kabir Mody; Edward Strauss; Robert Lincer; Richard C Frank
Journal:  BMC Cancer       Date:  2010-10-20       Impact factor: 4.430

8.  Pharmacokinetics of gemcitabine at fixed-dose rate infusion in patients with normal and impaired hepatic function.

Authors:  Alessandra Felici; Susanna Di Segni; Michele Milella; Simona Colantonio; Isabella Sperduti; Barbara Nuvoli; Michela Contestabile; Andrea Sacconi; Massimo Zaratti; Gennaro Citro; Francesco Cognetti
Journal:  Clin Pharmacokinet       Date:  2009       Impact factor: 6.447

Review 9.  Chemotherapy for the biliary tract cancers: moving toward improved survival time.

Authors:  Adriana Romiti; Chiara D'Antonio; Angelo Zullo; Ida Sarcina; Roberta Di Rocco; Viola Barucca; Valeria Durante; Paolo Marchetti
Journal:  J Gastrointest Cancer       Date:  2012-09

10.  Complementary effects of HDAC inhibitor 4-PB on gap junction communication and cellular export mechanisms support restoration of chemosensitivity of PDAC cells.

Authors:  O Ammerpohl; A Trauzold; B Schniewind; U Griep; C Pilarsky; R Grutzmann; H-D Saeger; O Janssen; B Sipos; G Kloppel; H Kalthoff
Journal:  Br J Cancer       Date:  2006-12-12       Impact factor: 7.640

  10 in total

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