OBJECTIVE: The purpose of this study was to investigate the impact of combinational versus sequential gemcitabine and platinum on prognosis of advanced pancreatic cancer. METHODS: Two hundred and three patients with advanced pancreatic cancer were selected. They were divided into GemP (first-line gemcitabine and platinum), Gem-then-P(sequential gemcitabine and platinum), Gem/other (first-line gemcitabine-based therapy without subsequent platinum),and Gem (first-line gemcitabine-based therapy without subsequent systemic therapy) groups. The Kaplan–Meier method and log-rank test were used for survival analyses. Cox regression model and propensity score matching were used for prognostic analyses. RESULTS: The median survival was 12.5 months [95 %confidence interval (CI), 11.2-13.7] in the GemP group(N = 65), 8.3 months (95 % CI 5.0-11.7) in the Gem-then-P group (N = 35), 11.6 months (95 % CI 4.6–18.5) in the Gem/other group (N = 26), and 4.7 months (95 % C I3.3-6.0) in the Gem group (N = 77) (P<0.001). Considering the GemP and Gem-then-P groups, performance status, serum creatinine, and response to first-line treatment were independent prognostic factors for overall survival in the multivariate analysis. No specific factors were identified for predicting the choice between GemP and Gem-then-P. CONCLUSIONS: First-line gemcitabine and platinum-based combinations were not superior to sequential gemcitabine and platinum for overall survival. The best sequence of chemotherapy for advanced pancreatic cancer should be explored in future clinical trials.
OBJECTIVE: The purpose of this study was to investigate the impact of combinational versus sequential gemcitabine and platinum on prognosis of advanced pancreatic cancer. METHODS: Two hundred and three patients with advanced pancreatic cancer were selected. They were divided into GemP (first-line gemcitabine and platinum), Gem-then-P(sequential gemcitabine and platinum), Gem/other (first-line gemcitabine-based therapy without subsequent platinum),and Gem (first-line gemcitabine-based therapy without subsequent systemic therapy) groups. The Kaplan–Meier method and log-rank test were used for survival analyses. Cox regression model and propensity score matching were used for prognostic analyses. RESULTS: The median survival was 12.5 months [95 %confidence interval (CI), 11.2-13.7] in the GemP group(N = 65), 8.3 months (95 % CI 5.0-11.7) in the Gem-then-P group (N = 35), 11.6 months (95 % CI 4.6–18.5) in the Gem/other group (N = 26), and 4.7 months (95 % C I3.3-6.0) in the Gem group (N = 77) (P<0.001). Considering the GemP and Gem-then-P groups, performance status, serum creatinine, and response to first-line treatment were independent prognostic factors for overall survival in the multivariate analysis. No specific factors were identified for predicting the choice between GemP and Gem-then-P. CONCLUSIONS: First-line gemcitabine and platinum-based combinations were not superior to sequential gemcitabine and platinum for overall survival. The best sequence of chemotherapy for advanced pancreatic cancer should be explored in future clinical trials.
Authors: Volker Heinemann; Ursula Vehling-Kaiser; Dirk Waldschmidt; Erika Kettner; Angela Märten; Cornelia Winkelmann; Stefan Klein; Georgi Kojouharoff; Thomas C Gauler; Ludwig Fischer von Weikersthal; Michael R Clemens; Michael Geissler; Tim F Greten; Susanna Hegewisch-Becker; Oleg Rubanov; Gerold Baake; Thomas Höhler; Yon D Ko; Andreas Jung; Sascha Neugebauer; Stefan Boeck Journal: Gut Date: 2012-07-07 Impact factor: 23.059
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Authors: Philip A Philip; Jacqueline Benedetti; Christopher L Corless; Ralph Wong; Eileen M O'Reilly; Patrick J Flynn; Kendrith M Rowland; James N Atkins; Barry C Mirtsching; Saul E Rivkin; Alok A Khorana; Bryan Goldman; Cecilia M Fenoglio-Preiser; James L Abbruzzese; Charles D Blanke Journal: J Clin Oncol Date: 2010-07-06 Impact factor: 44.544