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Second-line treatment with a combination of continuous 5-fluorouracil, doxorubicin, and mitomycin-C (conti-FAM) in gemcitabine-pretreated pancreatic and biliary tract cancer.
- Source :
-
American journal of clinical oncology [Am J Clin Oncol] 2009 Aug; Vol. 32 (4), pp. 348-52. - Publication Year :
- 2009
-
Abstract
- Background: Gemcitabine-based chemotherapy is a commonly used first-line treatment for patients with pancreatic and biliary tract cancer. However, a standard second-line chemotherapy regimen has yet to be developed after gemcitabine treatment. We attempted to evaluate the efficacy and safety of a combination of continuous 5-fluorouracil, doxorubicin, and mitomycin-C (conti-FAM) as a second-line treatment in pancreatic and biliary tract cancer.<br />Methods: Patients with advanced pancreatic or biliary tract cancer who were previously treated with gemcitabine-based chemotherapy were enrolled in the study. Chemotherapy was administered as follows: 5-fluorouracil, 800 mg/m2 on days 1 to 5 over 10 hours; mitomycin-C, 8 mg/m2 on day 1; and doxorubicin, 30 mg/m2 on day 1 every 4 weeks.<br />Results: A total of 31 patients received 95 cycles of chemotherapy. Fifteen of the patients had pancreatic cancer. Eleven of the patients had cholangiocarcinoma. Gallbladder cancer was observed in 5 patients. Four (12.9%) patients evidenced partial responses. Eight patients (25.8%) had stable disease. The median time to progression and overall survival time were 2.3 (95% CI: 1.0-3.6) months and 6.7 (95% CI: 4.4-9.0) months, respectively. Major hematologic toxicities included grade 1 to 2 anemia (64.2%), neutropenia (32.6%), thrombocytopenia (20%), and grade 3 to 4 neutropenia (10.5%). The most frequently detected nonhematological toxicities were grade 2 and 3 nausea/vomiting (35.5%). One patient was diagnosed with hemolytic uremic syndrome after 8 cycles of treatment.<br />Conclusion: The conti-FAM regimen seems to constitute a safe and feasible salvage therapy in patients with advanced bilio-pancreatic cancer who had been treated previously via gemcitabine-based chemotherapy.
- Subjects :
- Adenocarcinoma mortality
Adenocarcinoma pathology
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols adverse effects
Biliary Tract Neoplasms mortality
Biliary Tract Neoplasms pathology
Chi-Square Distribution
Deoxycytidine administration & dosage
Deoxycytidine adverse effects
Deoxycytidine analogs & derivatives
Dose-Response Relationship, Drug
Doxorubicin administration & dosage
Doxorubicin adverse effects
Drug Administration Schedule
Female
Fluorouracil administration & dosage
Fluorouracil adverse effects
Humans
Infusions, Intravenous
Kaplan-Meier Estimate
Male
Maximum Tolerated Dose
Middle Aged
Mitomycin administration & dosage
Mitomycin adverse effects
Neoplasm Staging
Pancreatic Neoplasms mortality
Pancreatic Neoplasms pathology
Probability
Proportional Hazards Models
Remission Induction methods
Risk Assessment
Survival Analysis
Gemcitabine
Adenocarcinoma drug therapy
Antineoplastic Combined Chemotherapy Protocols administration & dosage
Biliary Tract Neoplasms drug therapy
Neoadjuvant Therapy
Pancreatic Neoplasms drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1537-453X
- Volume :
- 32
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- American journal of clinical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 19363436
- Full Text :
- https://doi.org/10.1097/COC.0b013e31818c08ff