title: The efficacy of gemcitabine as salvage treatment in patients with refractory advanced colorectal cancer (CRC): a single institution experience.
abstract: OBJECTIVE
  To assess the efficacy of gemcitabine based chemotherapy in heavily pre-treated patients with advanced colorectal cancer.
  
  
  METHODS
  Patients, who had been treated with gemcitabine 1250-2000 mg/m² biweekly in combination with capecitabine 1700-2000 mg/m²/day, d1-7 every two weeks were retrospectively reviewed. All the patients had previously received at least three chemotherapy regimens and 12 (55%) had also received a 4th line regimen. All the patients had been treated with a monoclonal antibody either against vascular endothelial growth factor receptor (VEGFR) or endothelial growth factor receptor (EGFR) (only if wild-type KRAS). The patients had had blood tests weekly, carcinoembryonic antigen (CEA) level measurement every 4 weeks and radiological assessment of their disease with CT scans every 8/9 weeks.
  
  
  RESULTS
  Twenty two patients were included; male-female, 14:8; age ranged from 43-73 years. The majority of the patients (17/22) had performance status (PS) ECOG 0-1 and the remaining patients (5/22) had PS 2 at the time of initiation of the gemcitabine-based regimen. Thirteen patients demonstrated a clinical benefit (2 partial response, 2 minor response, 9 stable disease), 6 patients progressed and 2 were not evaluable.
  
  
  CONCLUSIONS
  Gemcitabine has a modest activity in heavily pre-treated colorectal cancer patients and may be an option in good performance status patients.
authors.affiliation: Columbia University College of Physicians and Surgeons and the Herbert Irving Cancer Center, New York, NY 10032, USA. mws2138@columbia.edu
authors.forename: Muhammad Wasif
authors.initials: MW
authors.lastname: Saif
authors.forename: Kristin
authors.initials: K
authors.lastname: Kaley
authors.forename: Robin
authors.initials: R
authors.lastname: Penney
authors.forename: Susan
authors.initials: S
authors.lastname: Hotchkiss
authors.forename: Kostas N
authors.initials: KN
authors.lastname: Syrigos
authors.forename: Alexios S
authors.initials: AS
authors.lastname: Strimpakos
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000188:drug therapy*; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016879:Salvage Therapy; D000093542:Gemcitabine
chemical_list: D000970:Antineoplastic Agents; D003841:Deoxycytidine; D000093542:Gemcitabine