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Journal of Clinical Oncology

Publication date: 2005-12-01
Volume: 23 Pages: 9250 -
Publisher: American Society of Clinical Oncology

Author:

Lutz, Manfred P
Van Cutsem, Eric ; Wagener, Theo ; Van Laethem, Jean-Luc ; Vanhoefer, Udo ; Wils, Jacques A ; Gamelin, Eric ; Koehne, Claus H ; Arnaud, Jean P ; Mitry, Emmanuel ; Husseini, Faress ; Reichardt, Peter ; El-Serafi, Mustafa ; Etienne, Pierre-Luc ; Lingenfelser, Thomas ; Praet, Michel ; Genicot, Bruno ; Debois, Muriel ; Nordlinger, Bernard ; Ducreux, Michel P

Keywords:

Adult, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols, Carcinoma, Cisplatin, Deoxycytidine, Disease Progression, Female, Humans, Infusions, Intravenous, Male, Middle Aged, Pancreatic Neoplasms, Survival Analysis, Taxoids, Science & Technology, Life Sciences & Biomedicine, Oncology, COLONY-STIMULATING FACTOR, CLINICAL-TRIALS-GROUP, CELL LUNG-CANCER, COMPARING GEMCITABINE, ONCOLOGY-GROUP, COMBINATION, CHEMOTHERAPY, ADENOCARCINOMA, RESISTANCE, INSTITUTE, Docetaxel, Gemcitabine, European Organisation for Research and Treatment of Cancer Gastrointestinal Group, 1103 Clinical Sciences, 1112 Oncology and Carcinogenesis, Oncology & Carcinogenesis, 3211 Oncology and carcinogenesis

Abstract:

PURPOSE: To define the efficacy and toxicity of docetaxel plus gemcitabine or docetaxel plus cisplatin for advanced pancreatic carcinoma. PATIENTS AND METHODS: Chemotherapy-naive patients with measurable disease and WHO performance status less than 2 were randomly assigned to receive 21-day cycles of gemcitabine 800 mg/m2 on days 1 and 8 plus docetaxel 85 mg/m2 on day 8 (arm A) or docetaxel 75 mg/m2 on day 1 plus cisplatin 75 mg/m2 on day 1 (arm B). Primary end points were tumor response and rate of febrile neutropenia grade. RESULTS: Of 96 randomly assigned patients (49 patients in arm A and 47 patients in arm B), 70 patients were analyzed for response (36 in arm A and 34 in arm B) and 89 patients were analyzed for safety (45 in arm A and 44 in arm B). Confirmed responses were observed in 19.4% (95% CI, 8.2% to 36.0%) of patients in arm A and 23.5% (95% CI, 10.7% to 41.2%) in arm B. In arm A, the median progression-free survival (PFS) was 3.9 months (95% CI, 3.0 to 4.7 months), median survival was 7.4 months (95% CI, 5.6 to 11.0 months), and 1-year survival was 30%. In arm B, the median PFS was 2.8 months (95% CI, 2.6 to 4.6 months), median survival was 7.1 months (95% CI, 4.8 to 8.7 months), and 1-year survival was 16%. Febrile neutropenia occurred in 9% and 16% of patients in arms A and B, respectively. CONCLUSION: Both regimens are well tolerated and show activity in advanced pancreatic carcinoma. The safety profile and survival analyses favor docetaxel plus gemcitabine for further evaluation.