title: Cisplatin-modified de Gramont in second-line therapy for pancreatic adenocarcinoma.
abstract: OBJECTIVE
  In Belgium, combination chemotherapy of cisplatin and 5-fluorouracil + leucovorin (CFL) according to the modified de Gramont schedule is the treatment of choice in second line for metastatic pancreatic cancer. We retrospectively analyzed survival data in 2 Belgian centers in a nonselected population.
  
  
  METHODS
  Between January 2004 and October 2011, 48 patients with histologically proven recurrent or unresectable pancreatic adenocarcinoma who had received CFL as second-line treatment were identified. We retrospectively analyzed the following parameters: progression-free survival (PFS1 and PFS2) for each line (after the start of first and second line), overall survival (OS), and growth modulation index.
  
  
  RESULTS
  The median PFS1 was 5.4 months (95% confidence interval [CI], 4.1-6.6). The median PFS2 was 3.6 months (95% CI, 2-5.2). The median OS was 12 months (95% CI, 9.3-14.7). Twenty-three percent of patients had a growth modulation index >1.33.
  
  
  CONCLUSIONS
  We show an OS of 12 months with gemcitabine in first-line and CFL in second-line therapy for pancreatic cancer. Sequential therapy with good OS and good quality of life may be preferred to strong upfront therapy in an incurable disease such as pancreatic cancer.
authors.affiliation: From the *Department of Digestive Oncology, Ghent University Hospital, Ghent, Belgium; †Calmette Hospital, Phnom Penh, Cambodia; ‡Department of Pathology, and §Department of General and Hepatobiliary Surgery, Ghent University Hospital, Ghent, Belgium; ∥Department of Gastroenterology, Maria Middelares Hospital, Ghent, Belgium; and ¶Department of Digestive Oncology, Ghent University Hospital, Ghent, Belgium.
authors.forename: Vutha
authors.initials: V
authors.lastname: Ky
authors.forename: Monirath
authors.initials: M
authors.lastname: Hav
authors.forename: Frederik
authors.initials: F
authors.lastname: Berrevoet
authors.forename: Roberto I
authors.initials: RI
authors.lastname: Troisi
authors.forename: Liesbeth
authors.initials: L
authors.lastname: Ferdinande
authors.forename: Els
authors.initials: E
authors.lastname: Monsaert
authors.forename: Eric
authors.initials: E
authors.lastname: Vanderstraeten
authors.forename: Katrien
authors.initials: K
authors.lastname: De Bosschere
authors.forename: Nancy
authors.initials: N
authors.lastname: Van Damme
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Laurent
authors.forename: Karen
authors.initials: K
authors.lastname: Geboes
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000556:secondary; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002945:Cisplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D053208:Kaplan-Meier Estimate; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000188:drug therapy*; D012189:Retrospective Studies; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D002945:Cisplatin; D002955:Leucovorin; D005472:Fluorouracil; D000093542:Gemcitabine