title: Combination Chemotherapy with Itraconazole for Treating Metastatic Pancreatic Cancer in the Second-line or Additional Setting.
abstract: BACKGROUND
  We evaluated chemotherapy with itraconazole (a common anti-fungal agent that is a potent inhibitor of the Hedgehog pathway, P-glycoprotein, and angiogenesis) for treating progressive pancreatic cancer.
  
  
  METHODS
  We retrospectively reviewed the medical charts of patients with histologically-diagnosed pancreatic cancer who had received first- or second-line chemotherapy and subsequent chemotherapy with itraconazole.
  
  
  RESULTS
  A total of 38 patients received docetaxel (35 mg/m(2)), gemcitabine (1,000 mg/m(2)), and carboplatin (area under the curve, 4 mg/min/ml) on day 1 and oral itraconazole solution (400 mg) on days -2 to 2, repeated every 2 weeks. One complete response and 13 partial responses were observed, for a response rate of 37%. Eight (21%) patients experienced febrile neutropenia. The median overall survival was 11.4 months (95% confidence interval=8.5-21.2 months).
  
  
  CONCLUSIONS
  Combination chemotherapy with itraconazole is promising for prolonging overall survival, with acceptable toxicities in the second-line setting of pancreatic cancer.
authors.affiliation: Department of Medical Oncology, Meiwa Hospital, Nishinomiya, Japan Department of Obstetrics and Gynecology, Hyogo College of Medicine, Nishinomiya, Japan tsuba@hyo-med.ac.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tsubamoto
authors.affiliation: Department of Medical Oncology, Meiwa Hospital, Nishinomiya, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Sonoda
authors.affiliation: Department of Surgery, Meiwa Hospital, Nishinomiya, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Ikuta
authors.affiliation: Department of Medical Oncology, Kohnan Hospital, Kobe, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tani
authors.affiliation: Department of Medical Oncology, Meiwa Hospital, Nishinomiya, Japan Department of Obstetrics and Gynecology, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Kayo
authors.initials: K
authors.lastname: Inoue
authors.affiliation: Department of Surgery, Meiwa Hospital, Nishinomiya, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Yamanaka
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077143:Docetaxel; D005260:Female; D006801:Humans; D017964:Itraconazole / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000188:drug therapy*; D012189:Retrospective Studies; D043823:Taxoids / Q000008:administration & dosage; D000093542:Gemcitabine
chemical_list: D043823:Taxoids; D003841:Deoxycytidine; D000077143:Docetaxel; D017964:Itraconazole; D016190:Carboplatin; D000093542:Gemcitabine
keywords: Hedgehog; Pancreatic cancer; itraconazole; second-line chemotherapy