A comprehensive update on the use of chemotherapy for metastatic pancreatic adenocarcinoma.
Phase II trials of combination chemotherapies have shown encouraging palliative benefit, objective response rates, and survival outcomes. Until ongoing phase III trials confirm these benefits, the current standard treatment for metastatic pancreatic adenocarcinoma remains single agent gemcitabine. The fixed rate infusion schedule of 10 mg/m2/min is gaining wide acceptance and is a promising investigational priority. A very reasonable alternative to single agent gemcitabine, and our bias, is enrollment into clinical trials evaluating novel gemcitabine-based combinations. Further investigation is needed to determine optimal incorporation of so-called targeted therapy with combination chemotherapy.
Kozuch
Peter
P
Department of Medical Oncology, St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, 425 West 59th Street, Suite 1A, New York, NY 10019, USA. pkozuch@slrhc.org
Petryk
Magdalena
M
Bruckner
Howard W
HW
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000556:secondary*; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001855:Bone Marrow Diseases / Q000139:chemically induced; D002166:Camptothecin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D017322:Clinical Trials, Phase II as Topic; D017326:Clinical Trials, Phase III as Topic; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000077143:Docetaxel; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D015251:Epirubicin / Q000008:administration & dosage; D005472:Fluorouracil / Q000008:administration & dosage / Q000627:therapeutic use; D006463:Hemolytic-Uremic Syndrome / Q000139:chemically induced; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage; D000077146:Irinotecan; D002955:Leucovorin / Q000008:administration & dosage; D015337:Multicenter Studies as Topic; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D017239:Paclitaxel / Q000008:administration & dosage / Q000031:analogs & derivatives*; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000473:pathology; D011994:Recombinant Proteins; D012128:Respiratory Distress Syndrome / Q000139:chemically induced; D043823:Taxoids; D016896:Treatment Outcome; D000093542:Gemcitabine
D000970:Antineoplastic Agents; D004791:Enzyme Inhibitors; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D009944:Organoplatinum Compounds; D011994:Recombinant Proteins; D043823:Taxoids; D003841:Deoxycytidine; D000077143:Docetaxel; D015251:Epirubicin; D000077146:Irinotecan; D017239:Paclitaxel; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin; D000093542:Gemcitabine