PURPOSE: To determine the maximum tolerated dose (MTD) and efficacy of pemetrexed and gemcitabine in patients with either biliary tract or gallbladder carcinoma. PATIENTS AND METHODS: Patients with unresectable previously untreated biliary tract cancers were eligible for participation. An initial phase I trial was performed to determine the MTD using an every-2-weeks schedule. The MTD was then used in the phase II portion of the trial. The primary end point for the phase II portion was 6-month survival with a planned accrual of 59 patients. RESULTS: Overall, 63 eligible patients were enrolled. The MTD was established as pemetrexed 500 mg/m2 IV over 10 min and gemcitabine 800 mg/m2 IV at 10 mg/m2 per minute on days 1 and 15 of an every-4-weeks schedule with vitamin B12 and folate supplementation. Fifty-eight patients were included in the phase II portion. Median age was 61 and median follow-up was 18.2 months. A median of three cycles of treatment was given. Six-month survival was 55% and the median survival was 6.6 months (95% confidence interval 5.4-8.7 months) with a median time to progression of 3.8 months (2.4-5.4). Forty-seven (81%) experienced at least one grade 3+ adverse event, and 28 patients (48%) experienced at least one grade 4 adverse event, most of which were due to grade 4 neutropenia. CONCLUSION: The addition of pemetrexed to fixed-dose-rate gemcitabine, in a biweekly schedule, did not enhance the activity of gemcitabine in patients with biliary tract or gallbladder carcinoma.
RCT Entities:
PURPOSE: To determine the maximum tolerated dose (MTD) and efficacy of pemetrexed and gemcitabine in patients with either biliary tract or gallbladder carcinoma. PATIENTS AND METHODS: Patients with unresectable previously untreated biliary tract cancers were eligible for participation. An initial phase I trial was performed to determine the MTD using an every-2-weeks schedule. The MTD was then used in the phase II portion of the trial. The primary end point for the phase II portion was 6-month survival with a planned accrual of 59 patients. RESULTS: Overall, 63 eligible patients were enrolled. The MTD was established as pemetrexed 500 mg/m2 IV over 10 min and gemcitabine 800 mg/m2 IV at 10 mg/m2 per minute on days 1 and 15 of an every-4-weeks schedule with vitamin B12 and folate supplementation. Fifty-eight patients were included in the phase II portion. Median age was 61 and median follow-up was 18.2 months. A median of three cycles of treatment was given. Six-month survival was 55% and the median survival was 6.6 months (95% confidence interval 5.4-8.7 months) with a median time to progression of 3.8 months (2.4-5.4). Forty-seven (81%) experienced at least one grade 3+ adverse event, and 28 patients (48%) experienced at least one grade 4 adverse event, most of which were due to grade 4 neutropenia. CONCLUSION: The addition of pemetrexed to fixed-dose-rate gemcitabine, in a biweekly schedule, did not enhance the activity of gemcitabine in patients with biliary tract or gallbladder carcinoma.
Authors: P Therasse; S G Arbuck; E A Eisenhauer; J Wanders; R S Kaplan; L Rubinstein; J Verweij; M Van Glabbeke; A T van Oosterom; M C Christian; S G Gwyther Journal: J Natl Cancer Inst Date: 2000-02-02 Impact factor: 13.506
Authors: M Penz; G V Kornek; M Raderer; H Ulrich-Pur; W Fiebiger; A Lenauer; D Depisch; G Krauss; B Schneeweiss; W Scheithauer Journal: Ann Oncol Date: 2001-02 Impact factor: 32.976
Authors: H Oettle; D Richards; R K Ramanathan; J L van Laethem; M Peeters; M Fuchs; A Zimmermann; W John; D Von Hoff; M Arning; H L Kindler Journal: Ann Oncol Date: 2005-08-08 Impact factor: 32.976
Authors: Margaret Tempero; William Plunkett; Veronique Ruiz Van Haperen; John Hainsworth; Howard Hochster; Renato Lenzi; James Abbruzzese Journal: J Clin Oncol Date: 2003-07-28 Impact factor: 44.544
Authors: Frank Boxberger; Barbara Jüngert; Valeska Brueckl; Wolfgang M Brueckl; Martina Hautmann; Werner Hohenberger; Eckhart G Hahn; Axel Wein Journal: Anticancer Drugs Date: 2003-01 Impact factor: 2.248
Authors: Susanna V Ulahannan; Osama E Rahma; Austin G Duffy; Oxana V Makarova-Rusher; Metin Kurtoglu; David J Liewehr; Seth M Steinberg; Tim F Greten Journal: Hepat Oncol Date: 2015-01-01