title: Raltitrexed-eloxatin salvage chemotherapy in gemcitabine-resistant metastatic pancreatic cancer.
abstract: Limited information on salvage treatment in patients affected by pancreatic cancer is available. At failure, about half of the patients present good performance status (PS) and are candidate for further treatment. Patients >18 years, PS >or=50, with metastatic pancreatic adenocarcinoma previously treated with gemcitabine-containing chemotherapy, and progression-free survival (PFS) <12 months received a combination of raltitrexed (3 mg m(-2)) and oxaliplatin (130 mg m(-2)) every 3 weeks until progression, toxicity, or a maximum of six cycles. A total of 41 patients received 137 cycles of chemotherapy. Dose intensity for both drugs was 92% of the intended dose. Main grade >2 toxicity was: neutropenia in five patients (12%), thrombocytopenia, liver and vomiting in three (7%), fatigue in two (5%). In total, 10 patients (24%) yielded a partial response, 11 a stable disease. Progression-free survival at 6 months was 14.6%. Median survival was 5.2 months. Survival was significantly longer in patients with previous PFS >6 months and in patients without pancreatic localisation. A clinically relevant improvement of quality of life was observed in numerous domains. Raltitrexed-oxaliplatin regimen may constitute a treatment opportunity in gemcitabine-resistant metastatic pancreatic cancer. Previous PFS interval may allow the identification of patients who are more likely to benefit from salvage treatment.
authors.affiliation: Department of Oncology, S. Raffaele Hsc. Scientific Inst., via Olgettina 60, 20132 Milan, Italy. reni.michele@hsr.it
authors.forename: M
authors.initials: M
authors.lastname: Reni
authors.forename: L
authors.initials: L
authors.lastname: Pasetto
authors.forename: G
authors.initials: G
authors.lastname: Aprile
authors.forename: S
authors.initials: S
authors.lastname: Cordio
authors.forename: E
authors.initials: E
authors.lastname: Bonetto
authors.forename: S
authors.initials: S
authors.lastname: Dell'Oro
authors.forename: P
authors.initials: P
authors.lastname: Passoni
authors.forename: L
authors.initials: L
authors.lastname: Piemonti
authors.forename: C
authors.initials: C
authors.lastname: Fugazza
authors.forename: G
authors.initials: G
authors.lastname: Luppi
authors.forename: C
authors.initials: C
authors.lastname: Milandri
authors.forename: R
authors.initials: R
authors.lastname: Nicoletti
authors.forename: A
authors.initials: A
authors.lastname: Zerbi
authors.forename: G
authors.initials: G
authors.lastname: Balzano
authors.forename: V
authors.initials: V
authors.lastname: Di Carlo
authors.forename: A A
authors.initials: AA
authors.lastname: Brandes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000494:pharmacology; D018450:Disease Progression; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000473:pathology; D011788:Quality of Life; D011799:Quinazolines / Q000008:administration & dosage; D016879:Salvage Therapy; D016019:Survival Analysis; D013876:Thiophenes / Q000008:administration & dosage; D000093542:Gemcitabine
chemical_list: D009944:Organoplatinum Compounds; D011799:Quinazolines; D013876:Thiophenes; D000077150:Oxaliplatin; D003841:Deoxycytidine; C068874:raltitrexed; D000093542:Gemcitabine