Comparison of gemcitabine versus the matrix metalloproteinase inhibitor BAY 12-9566 in patients with advanced or metastatic adenocarcinoma of the pancreas: a phase III trial of the National Cancer Institute of Canada Clinical Trials Group.
OBJECTIVE
To compare the selective matrix metalloproteinase inhibitor BAY 12-9566 with the nucleoside analog gemcitabine in the treatment of advanced pancreatic cancer.


METHODS
Patients with advanced pancreatic adenocarcinoma who had not previously received chemotherapy were randomly assigned to receive BAY 12-9566 800 mg orally bid continuously or gemcitabine 1,000 mg/m2 administered intravenously on days 1, 8, 15, 22, 29, 36, and 43 for the first 8 weeks, and then days 1, 8, and 15 of each subsequent 28-day cycle. The primary end point was overall survival; secondary end points were progression-free survival, tumor response, quality of life, and clinical benefit. The planned sample size of the study was 350 patients. Two formal interim analyses were planned.


RESULTS
The study was closed to accrual after the second interim analysis on the basis of the recommendation of the National Cancer Institute of Canada Clinical Trials Group Data Safety Monitoring Committee. There were 277 patients enrolled onto the study, 138 in the BAY 12-9566 arm and 139 in the gemcitabine arm. The rates of serious toxicity were low in both arms. The median survival for the BAY 12-9566 arm and the gemcitabine arm was 3.74 months and 6.59 months, respectively (P <.001; stratified log-rank test). The median progression-free survival for the BAY 12-9566 and gemcitabine arms was 1.68 and 3.5 months, respectively (P <.001). Quality-of-life analysis also favored gemcitabine.


CONCLUSIONS
Gemcitabine is significantly superior to BAY 12-9566 in advanced pancreatic cancer.
Moore
M J
MJ
Department of Medical Oncology, Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada. malcolm.moore@uhn.on.ca.
Hamm
J
J
Dancey
J
J
Eisenberg
P D
PD
Dagenais
M
M
Fields
A
A
Hagan
K
K
Greenberg
B
B
Colwell
B
B
Zee
B
B
Tu
D
D
Ottaway
J
J
Humphrey
R
R
Seymour
L
L
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000473:pathology; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001713:Biphenyl Compounds; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis; D009930:Organic Chemicals; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000473:pathology; D010654:Phenylbutyrates; D016016:Proportional Hazards Models; D011788:Quality of Life; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D016896:Treatment Outcome; D000093542:Gemcitabine
D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D001713:Biphenyl Compounds; D009930:Organic Chemicals; D010654:Phenylbutyrates; D003841:Deoxycytidine; C113281:Bay 12-9566; D000093542:Gemcitabine