title: Low molecular weight heparin (LMWH) increases the efficacy of cisplatinum plus gemcitabine combination in advanced pancreatic cancer.
abstract: BACKGROUND
  In this non-randomized study we aimed to assess the efficacy of the addition of low molecular weight heparin (LMWH) to gemcitabine (GEM) plus cisplatinum (CDDP) combination chemotherapy on survival by prevention of thromboembolic complications in patients with advanced pancreatic cancer (APC).
  
  
  METHODS
  Between November 1999 and February 2004, 69 consecutive patients with APC were treated with GEM (800 mg/m2, day 1, day 8) plus CDDP (35 mg/m2, day 1, day 8) every 21 days +/-LMWH (nadroparine calcium, 2,850 IU/day until disease progression). Ten out of 35 patients in LMWH group and 10 out of 34 patients in chemotherapy alone group had primary inoperable locally advanced disease and the rest of the patients had metastatic disease.
  
  
  RESULTS
  Total response rate was 58.8% (11.7% CR) for the patients treated with LMWH and 12.1% for those treated without LMWH (P = 0.0001). LMWH group had a better median time to progression (TTP) and survival when compared to control group (7.3 vs. 4.0 months, P = 0.0001; 13.0 vs. 5.5 months, P = 0.0001). The toxicity was similar and acceptable in both groups.
  
  
  CONCLUSIONS
  Addition of LMWH to GEM plus CDDP combination significantly improved the response and survival in patients with APC and the current schedule deserves to be tested in phase III trials.
authors.affiliation: Department of Medical Oncology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Fikri
authors.initials: F
authors.lastname: Icli
authors.forename: Hakan
authors.initials: H
authors.lastname: Akbulut
authors.forename: Gungor
authors.initials: G
authors.lastname: Utkan
authors.forename: Bülent
authors.initials: B
authors.lastname: Yalcin
authors.forename: Dilek
authors.initials: D
authors.lastname: Dincol
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Isikdogan
authors.forename: Ahmet
authors.initials: A
authors.lastname: Demirkazik
authors.forename: Handan
authors.initials: H
authors.lastname: Onur
authors.forename: Filiz
authors.initials: F
authors.lastname: Cay
authors.forename: Abdullah
authors.initials: A
authors.lastname: Büyükcelik
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004334:Drug Administration Schedule; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D009503:Neutropenia / Q000139:chemically induced; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000401:mortality; D015996:Survival Rate; D013923:Thromboembolism / Q000150:complications*; D014840:Vomiting, Anticipatory / Q000209:etiology; D000093542:Gemcitabine
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D003841:Deoxycytidine; D002945:Cisplatin; D000093542:Gemcitabine