title: Biweekly gemcitabine and low-dose cisplatin in the treatment of locally advanced or metastatic pancreatic cancer patients: a single institute experience.
abstract: Gemcitabine in combination with low-dose cisplatin has shown promising activity in pancreatic cancer with manageable toxicities. The purpose of this study is to assess the activity of a combination of gemcitabine and low-dose cisplatin in the first-line treatment of metastatic and locally advanced pancreatic cancer patients. We conducted a retrospective analysis of all patients diagnosed with metastatic and locally advanced pancreatic cancer who received a combination of gemcitabine and cisplatin in the first-line setting. Patients with baseline cytopenias and elevated liver function tests were included. Patients received cisplatin at 20 mg per square meter followed by gemcitabine at a dose of 1000 mg per square meter at fixed dose rate every 2 weeks. Patients were treated until disease progression or unacceptable toxicities. A total of 58 patients were included in the analysis. The median progression-free survival was 4.4 months [95 % confidence interval (CI) 3.6-6.4], and median overall survival was 6.7 months (95 % CI 4.4-10.9). Thirty-eight patients (66 %) experienced at least one grade 3 or 4 toxicity. The most common grade 3 or 4 toxicity was hematologic toxicity (25 patients, 43 %). Biweekly fixed dose rate gemcitabine combined with low-dose cisplatin shows interesting activity in advanced pancreatic cancer. This regimen is an acceptable alternative for patients ineligible for gemcitabine plus nab-paclitaxel (i.e., those with elevated bilirubin at baseline) or clinical trials. Additionally, this regimen should be considered as a first-line option for those patients with breast cancer susceptibility gene mutations (BRCA1 and/or BRCA2).
authors.affiliation: The Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University, 460 West 10th Ave, C150, Columbus, OH, 43210, USA. Jordan.Lundberg@osumc.edu.
authors.forename: Jordan
authors.identifier: http://orcid.org/0000-0002-0469-974X
authors.initials: J
authors.lastname: Lundberg
authors.affiliation: The Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University, 460 West 10th Ave, C150, Columbus, OH, 43210, USA.
authors.forename: Joshua
authors.initials: J
authors.lastname: Reardon
authors.affiliation: The Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University, 460 West 10th Ave, C150, Columbus, OH, 43210, USA.
authors.forename: Marlo
authors.initials: M
authors.lastname: Blazer
authors.affiliation: Center for Biostatistics, The Ohio State University, Columbus, OH, USA.
authors.forename: Gary
authors.initials: G
authors.lastname: Phillips
authors.affiliation: The Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University, 460 West 10th Ave, C150, Columbus, OH, 43210, USA.
authors.forename: Tanios
authors.initials: T
authors.lastname: Bekaii-Saab
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000401:mortality; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D002945:Cisplatin; D000093542:Gemcitabine
keywords: Cisplatin; Fixed dose; Gemcitabine; Pancreatic