title: A multicenter analysis of GTX chemotherapy in patients with locally advanced and metastatic pancreatic adenocarcinoma.
abstract: OBJECTIVE
  Studies treating adenocarcinoma of the pancreas with gemcitabine alone or in combination with a doublet have demonstrated modest improvements in survival. Recent reports have suggested that using the triple-drug regimen FOLFIRINOX can substantially extend survival in patients with metastatic disease. We were interested in determining the clinical benefit of another three-drug regimen of gemcitabine, docetaxel and capecitabine (GTX) in patients with advanced pancreatic adenocarcinoma.
  
  
  METHODS
  The cases of 154 patients, who received treatment with GTX chemotherapy with histologically confirmed locally advanced or metastatic pancreatic adenocarcinoma, were retrospectively reviewed. All demographic and clinical data were captured including prior therapy, adverse events, treatment response and survival.
  
  
  RESULTS
  One hundred and seventeen metastatic and 37 locally advanced cases of adenocarcinoma of the pancreas were reviewed. Partial responses were noted in 11% of cases, and stable disease was observed in 62% of patients. Responses significantly correlated with toxicity (neutropenia, ALT elevation and hospitalizations). Grade 3 or greater hematologic and non-hematologic toxicities were noted in 41% and 9% of cases, respectively. Overall median survival was 11.6 months. Chemotherapy naïve patients with metastatic and locally advanced disease achieved a median survival of 11.3 and 25.0 months, respectively.
  
  
  CONCLUSIONS
  We observe a substantial survival benefit with GTX chemotherapy in our cohort of patients with advanced pancreatic cancer. These findings warrant further investigation of this combination in this patient population.
authors.affiliation: Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, 1650 Orleans Street, CRB I, Room 590, Baltimore, MD 21231, USA.
authors.forename: Ana
authors.initials: A
authors.lastname: De Jesus-Acosta
authors.forename: George R
authors.initials: GR
authors.lastname: Oliver
authors.forename: Amanda
authors.initials: A
authors.lastname: Blackford
authors.forename: Katharine
authors.initials: K
authors.lastname: Kinsman
authors.forename: Edna I
authors.initials: EI
authors.lastname: Flores
authors.forename: Lalan S
authors.initials: LS
authors.lastname: Wilfong
authors.forename: Lei
authors.initials: L
authors.lastname: Zheng
authors.forename: Ross C
authors.initials: RC
authors.lastname: Donehower
authors.forename: David
authors.initials: D
authors.lastname: Cosgrove
authors.forename: Daniel
authors.initials: D
authors.lastname: Laheru
authors.forename: Dung T
authors.initials: DT
authors.lastname: Le
authors.forename: Ki
authors.initials: K
authors.lastname: Chung
authors.forename: Luis A
authors.initials: LA
authors.lastname: Diaz
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000378:metabolism; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D000069287:Capecitabine; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D000077143:Docetaxel; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009503:Neutropenia / Q000139:chemically induced; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000473:pathology; D012189:Retrospective Studies; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D043823:Taxoids; D003841:Deoxycytidine; D000077143:Docetaxel; D000069287:Capecitabine; D000410:Alanine Transaminase; D005472:Fluorouracil; D000093542:Gemcitabine