Phase I-Ii Trial of Weekly Gemcitabine Plus High-Dose 5-Fluorouracil and Leucovorin in Advanced Pancreatic Cancer
Resource
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY v.21 n.3 pp.531-536
Journal
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
Journal Volume
v.21
Journal Issue
n.3
Pages
531-536
Date Issued
2006
Date
2006
Author(s)
CHENG, ANN-LII
HSU, CHIUN
HSU, CHIH-HUNG
Abstract
Background: Pancreatic cancer is a dismal disease. Few drugs , including gemcitabine and 5-fluorouracil (5-FU), have notable antitumor effects against advanced pancreatic cancer . The purpose of the present study was to determine the maximum tolerated dose (MTD) of 5-FU and the efficacy and toxicity profile of weekly gemcitabine plus infusional 5-FU/ leucovorin in advanced pancreatic cancer. Methods: Patients with histo-/cytologically confirmed, advanced pancreatic cancer were eligible. Treatment consisted of a 30-min infusion of gemcitabine (800 mg/m(2)), followed by a 24-h infusion of 5-FU and leucovorin (300 mg/m(2)) at day 1, day 8 and day 15 every 28 days, and was termed the GemFL(24) regimen. The dose of 5-FU was escalated from 1600, 2000, to 2600 mg/m(2) in the phase I study, and fixed MTD for subsequent enrolled patients. Results: Eighteen patients were enrolled in the phase I study, and 24 in phase II. The MTD of 5-FU was 2000 mg/m(2), with major dose-limiting toxicities being febrile neutropenia and delayed recovery from neutropenia. The dose intensity of gemcitabine of the 35 patients with 5-FU dosage set at MTD was 593 mg/m(2) per week. In the entire series of 42 patients, myelosuppression was the main toxicity, with grade 3 neutropenia in eight patients, and grade 3/4 thrombocytopenia in six. On an intention-to-treat analysis, the overall and clinical benefit response rates were 22% and 46%, respectively; with median progression-free and overall survival of 4.1 and 6.9 months, respectively. Conclusions: The GemFL(24) regimen is a feasible and moderately active treatment with manageable toxicities for advanced pancreatic cancer, and could be a basis for further combination with other anticancer drugs. ( C) 2005 Blackwell Publishing Asia Pty Ltd.
Subjects
5-fluorouracil
gemcitabine
high dose
leucovorin
pancreatic cancer
SDGs
Type
journal article