Gemcitabine in the treatment of advanced pancreatic cancer: a comparative analysis of randomized trials.
In view of the data available from randomized trials, gemcitabine has been established as a new standard for the treatment of pancreatic cancer. It was shown to improve clinical benefit response, time to progression, and survival when compared with agents such as 5-fluorouracil or metalloproteinase inhibitors. In one trial, the combination of cisplatin and gemcitabine significantly improved tumor response and time to progression as compared with gemcitabine alone, while a significant impact on survival yet needs to be shown. No significant, clinically meaningful survival benefit was observed when gemcitabine was combined with bolus or infusional 5-fluorouracil, capecitabine, metalloproteinase inhibitors, or the FTI tipifarnib. Numerous ongoing randomized trials are presently investigating gemcitabine-based combination regimens involving such agents as cisplatin, oxaliplatin, irinotecan, docetaxel, 5-fluorouracil, capecitabine, or pemetrexed.
Heinemann
Volker
V
Department of Hematology/Oncology, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Germany.
D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001713:Biphenyl Compounds; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000069287:Capecitabine; D002945:Cisplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D000077143:Docetaxel; D005472:Fluorouracil / Q000008:administration & dosage / Q000627:therapeutic use; D005971:Glutamates / Q000008:administration & dosage; D006147:Guanine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D006801:Humans; D006877:Hydroxamic Acids / Q000008:administration & dosage / Q000627:therapeutic use; D000077146:Irinotecan; D009930:Organic Chemicals; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D017239:Paclitaxel / Q000008:administration & dosage / Q000031:analogs & derivatives*; D010190:Pancreatic Neoplasms / Q000188:drug therapy*; D000068437:Pemetrexed; D010654:Phenylbutyrates; D015363:Quinolones / Q000008:administration & dosage; D016032:Randomized Controlled Trials as Topic; D043823:Taxoids; D000093542:Gemcitabine
D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D001713:Biphenyl Compounds; D005971:Glutamates; D006877:Hydroxamic Acids; D009930:Organic Chemicals; D009944:Organoplatinum Compounds; D010654:Phenylbutyrates; D015363:Quinolones; D043823:Taxoids; D000068437:Pemetrexed; D000077150:Oxaliplatin; D003841:Deoxycytidine; D000077143:Docetaxel; D006147:Guanine; D000069287:Capecitabine; D000077146:Irinotecan; C113281:Bay 12-9566; C100342:marimastat; C402769:tipifarnib; D017239:Paclitaxel; D002945:Cisplatin; D005472:Fluorouracil; D002166:Camptothecin; D000093542:Gemcitabine