Thierry Conroy1, Céline Gavoille, Antoine Adenis. 1. Department of Medical Oncology, Centre Alexis Vautrin, Nancy University, Vandoeuvre-lès-Nancy, France. t.conroy@nancy.fnclcc.fr
Abstract
PURPOSE OF REVIEW: Metastatic pancreatic ductal adenocarcinoma has a grim prognosis and gemcitabine has been the reference treatment for 15 years. In this article, we will review current first-line treatments for metastatic pancreatic adenocarcinoma focusing on randomized studies. RECENT FINDINGS: Among the numerous randomized phase III studies comparing gemcitabine as single agent to gemcitabine combined to a new agent, only the gemcitabine-erlotinib combination has shown a small, but statistical improvement in survival. A trend to better survival was also observed with a gemcitabine-capecitabine regimen. The use of low-weight heparin may be of value to reduce venous thromboembolic events. In selected patients with good performance status ECOG 0-1, the Folfirinox regimen, when compared with gemcitabine, was associated with more toxicities and significantly increased median survival from 6.8 to 11.1 months. SUMMARY: Gemcitabine (with or without erlotinib or capecitabine) is still the reference treatment in patients with ECOG performance status 2. Folfirinox is a new more toxic and more efficient regimen that may be considered in patients with good performance status.
PURPOSE OF REVIEW: Metastatic pancreatic ductal adenocarcinoma has a grim prognosis and gemcitabine has been the reference treatment for 15 years. In this article, we will review current first-line treatments for metastatic pancreatic adenocarcinoma focusing on randomized studies. RECENT FINDINGS: Among the numerous randomized phase III studies comparing gemcitabine as single agent to gemcitabine combined to a new agent, only the gemcitabine-erlotinib combination has shown a small, but statistical improvement in survival. A trend to better survival was also observed with a gemcitabine-capecitabine regimen. The use of low-weight heparin may be of value to reduce venous thromboembolic events. In selected patients with good performance status ECOG 0-1, the Folfirinox regimen, when compared with gemcitabine, was associated with more toxicities and significantly increased median survival from 6.8 to 11.1 months. SUMMARY:Gemcitabine (with or without erlotinib or capecitabine) is still the reference treatment in patients with ECOG performance status 2. Folfirinox is a new more toxic and more efficient regimen that may be considered in patients with good performance status.
Authors: Mert Erkan; Simone Hausmann; Christoph W Michalski; Alexander A Fingerle; Martin Dobritz; Jörg Kleeff; Helmut Friess Journal: Nat Rev Gastroenterol Hepatol Date: 2012-06-19 Impact factor: 46.802
Authors: Sil Kordes; Dick J Richel; Heinz-Josef Klümpen; Mariëtte J Weterman; Arnoldus J W M Stevens; Johanna W Wilmink Journal: Invest New Drugs Date: 2012-02-25 Impact factor: 3.850
Authors: Mert Erkan; Simone Hausmann; Christoph W Michalski; Anna M Schlitter; Alexander A Fingerle; Martin Dobritz; Helmut Friess; Jörg Kleeff Journal: Front Physiol Date: 2012-10-02 Impact factor: 4.566
Authors: Martin Chopra; Isabell Lang; Steffen Salzmann; Christina Pachel; Sabrina Kraus; Carina A Bäuerlein; Christian Brede; Ana-Laura Jordán Garrote; Katharina Mattenheimer; Miriam Ritz; Stefanie Schwinn; Carolin Graf; Viktoria Schäfer; Stefan Frantz; Hermann Einsele; Harald Wajant; Andreas Beilhack Journal: PLoS One Date: 2013-09-30 Impact factor: 3.240