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Dig Liver Dis. 2011 Mar;43(3):225-30. doi: 10.1016/j.dld.2010.09.010. Epub 2010 Nov 2.

Treatment trends in metastatic pancreatic cancer patients: Is it time to change?

Author information

  • 1Department of Oncology, San Raffaele Scientific Institute, Via olgettina 60, Milan, Italy. reni.michele@hsr.it

Abstract

BACKGROUND:

Since gemcitabine became the standard treatment for metastatic pancreatic adenocarcinoma, combination chemotherapy obtained conflicting impact on survival (OS).

AIMS:

To evaluate Italian treatment trends in metastatic pancreatic cancer.

METHODS:

Data on treatment outcome of 943 chemo-naive patients with pathological diagnosis of stage IV pancreatic adenocarcinoma treated between 1997 and 2007 in Italian centres were analysed.

RESULTS:

Four treatment groups could be identified: (1) single agent gemcitabine (N=529); (2) gemcitabine-platinating agent doublets (N=105); (3) gemcitabine-free three-drug intraarterial combination (N=75); (4) four-drug gemcitabine-cisplatin-fluoropyrimidine based combinations (N=170). Median and actuarial 1 y OS of the whole population were 6.2 months and 20%, respectively. Gemcitabine (median OS 5.1 months) appeared significantly inferior to gemcitabine-free triplets (median OS 6.0 months; p=.04), gemcitabine-platinating agent doublets (median OS 7.4 months; p=.00001), or gemcitabine-based four drug combinations (median OS 9.1 months; p<.00001).

CONCLUSION:

These data mirror the Italian clinical practice in the therapeutic management of pancreatic cancer and suggest that four-drug combination chemotherapy may be included amongst the candidate regimens for phase III testing.

PMID:
21044873
DOI:
10.1016/j.dld.2010.09.010
[PubMed - indexed for MEDLINE]
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