title: Treatment with combined streptozotocin and liposomal doxorubicin in metastatic endocrine pancreatic tumors.
abstract: Treatment with combined streptozotocin and liposomal doxorubicin is safe and efficient in patients with endocrine pancreatic tumors (EPTs). No cardiac toxicity was reported.
  
  
  BACKGROUND
  The combination of streptozotocin and doxorubicin has been shown to be superior to streptozotocin and fluorouracil in the treatment of metastatic EPTs. However, the risk of cardiac toxicity from anthracyclins hampers the usefulness of the drug combination. Liposomal doxorubicin has a lower frequency of cardiac adverse events compared to doxorubicin. We wanted to assess the efficacy and safety of combined streptozotocin and liposomal doxorubicin in patients with metastatic EPTs.
  
  
  METHODS
  Thirty patients with metastatic EPTs were recruited from three medical centers in Norway and Sweden during a time period of 3 years. All patients had histopathologically confirmed diagnoses and bidimensionally measurable lesions. 30 mg/m(2) of liposomal doxorubicin was administered on day 1 of each cycle. During the first course, 1 g of streptozotocin was given on 5 consecutive days. Thereafter, 2 g of streptozotocin was given on day 1 only. Treatment was repeated every 3 weeks.
  
  
  RESULTS
  Twelve of 30 patients (40%) achieved an objective radiological response with a median duration of 9 months. Stabilization of disease was achieved in 17 of 30 patients (57%) for a median duration of 11 months. Only one patient had progressive disease as best response. The 2-year progression-free survival was 18% and the 2-year overall survival was 72%. The treatment was well tolerated. None of the patients experienced cardiac toxicity.
  
  
  CONCLUSIONS
  We conclude that combined streptozotocin and liposomal doxorubicin is a safe and efficient treatment for EPTs. The efficacy seems to be comparable to that of combined streptozotocin and doxorubicin, whereas the cardiac toxicity clearly favors using the liposomal drug combination.
authors.affiliation: Department of Oncology, Uppsala University, Uppsala, Sweden. marie-louise.fjallskog@medsci.uu.se
authors.forename: Marie-Louise H
authors.initials: ML
authors.lastname: Fjallskog
authors.forename: Eva T
authors.initials: ET
authors.lastname: Janson
authors.forename: Ursula G
authors.initials: UG
authors.lastname: Falkmer
authors.forename: Morten H
authors.initials: MH
authors.lastname: Vatn
authors.forename: Kjell E
authors.initials: KE
authors.lastname: Oberg
authors.forename: Barbro K
authors.initials: BK
authors.lastname: Eriksson
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D004317:Doxorubicin / Q000008:administration & dosage; D004701:Endocrine Gland Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000556:secondary; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary*; D011446:Prospective Studies; D013311:Streptozocin / Q000008:administration & dosage; D015996:Survival Rate
chemical_list: D013311:Streptozocin; D004317:Doxorubicin