Gemcitabine/fluorouracil an effective palliative for pancreatic cancer

A regimen that combines gemcitabine with fluorouracil is well tolerated by patients with advanced pancreatic cancer and produces a clinical response rate above 50%, Greek researchers report.

Gemcitabine is currently the standard treatment for advanced pancreatic cancer, but its impact on patient survival is modest, Dr. Aristides Polyzos of Athens University School of Medicine and colleagues note. Fluorouracil widely used before the advent of gemcitabine, works consistently in the disease, while studies have shown it does not produce cross-resistance to the newer drug.Dr. Polyzos and colleagues conducted the current study to evaluate a combination of the two drugs. Forty-eight patients with metastatic disease were given 1000 mg/m2 of gemcitabine intravenously on day one and eight and fluorouracil 350mg/m2 with folinic acid on days one, two, eight and nine. The treatment was repeated every three weeks for a year or until disease progressed.There was a 21% objective response rate, while the clinical-benefit response exceeded 50%, the researchers write. Median time to progression was six months. Median survival was seven months, which was “relatively significant,” they add, because 90% of the patients had metastases to the liver. Among the 44 patients in whom evaluation of clinical response was possible, 70% reported improvement in pain, 52% reported improved performance status, and 28% gained weight.”The regimen of gemcitabine and fluorouracil administered in this study was well tolerated and showed a moderate antitumor activity and a significant palliative effect on tumor-related symptoms,” the researchers conclude. “Because fluorouracil is a low toxicity combination agent for gemcitabine, other forms of the two-drug combination warrant further investigation.”(Source: Clinical Drug Investigation 2004;24:661-670: Reuters Health: Oncolink: January 2005.)