title: A Phase II trial of fixed dose rate gemcitabine in patients with advanced biliary tree carcinoma.
abstract: Gemcitabine is a commonly used chemotherapy for biliary tree carcinomas, achieving response rates of 10% to 60%. Preclinical studies indicate that fixed dose rate infusion optimizes accumulation of gemcitabine triphosphate and may enhance the clinical activity of gemcitabine. We conducted a phase II study of fixed dose rate gemcitabine in 15 chemotherapy-naive patients with advanced cholangiocarcinoma and gallbladder carcinoma. Gemcitabine was administered at a dose of 1500 mg/m2 over 150 minutes weekly for 3 weeks every 28 days. Fourteen patients were evaluable for response. No complete or partial responses were observed. Two patients (13%) had stable disease lasting a median of 9 weeks. The median time to progression was 9 weeks; median survival was 20 weeks. There was considerable grade 3/4 hematologic toxicity, including neutropenia in 49% of patients, leukopenia in 40%, anemia in 27%, and thrombocytopenia in 27%. Grade 3/4 nonhematologic toxicities were minimal. We conclude that fixed dose rate gemcitabine results in significant myelosuppression and has minimal activity in patients with biliary tree carcinoma.
authors.affiliation: Department of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, IL, USA. ceng@mdanderson.org
authors.forename: Cathy
authors.initials: C
authors.lastname: Eng
authors.forename: Ramesh K
authors.initials: RK
authors.lastname: Ramanathan
authors.forename: Ramesh K
authors.initials: RK
authors.lastname: Ramathan
authors.forename: Michael K
authors.initials: MK
authors.lastname: Wong
authors.forename: Scot C
authors.initials: SC
authors.lastname: Remick
authors.forename: Lanting
authors.initials: L
authors.lastname: Dai
authors.forename: Kurombi T
authors.initials: KT
authors.lastname: Wade-Oliver
authors.forename: Sridhar
authors.initials: S
authors.lastname: Mani
authors.forename: Hedy L
authors.initials: HL
authors.lastname: Kindler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000627:therapeutic use*; D001650:Bile Duct Neoplasms / Q000188:drug therapy*; D018281:Cholangiocarcinoma / Q000188:drug therapy*; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D005260:Female; D005706:Gallbladder Neoplasms / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000093542:Gemcitabine