308 Background: Pancreatic and biliary tree ADC represent poor prognostic tumors. Gemcitabine is usually considered the first- line chemotherapy and after that no standard treatment has been established. CAP and OX have demonstrated some activity in metastatic (M1) and locally advanced (LA) pancreatic cancer, and the combination of these drugs confers additional benefit as well. We conducted this study in order to establish the efficacy of this schedule on pancreatic and biliary tree ADC. Methods: Pts with M1 or LA pancreatic or biliary tree ADC with progression to one previous chemotherapy treatment were included. Performance status≤2, age≥18 years and adequate renal and hepatic function were selected. Schedule of chemotherapy: CAP 1000 mg/m2 bid on days 2 to 15 and OX 130 mg/m2 on day 1 of a 3-week cycle. RECIST criteria were used for assessment of response and NCI-CTCAE v 3.0 for toxicity. Results: Between April 2006 and March 2010, 40 pt were included. Male/female: 29/11. Mean age: 60.7 years (37-74). Pancreatic/biliary: 23/17. PS 0/1/2: 3/27/10. LA/ M1: 1/39. Mean number of cycles: 2.50 (1-10). Disease response per pt, partial/ stable disease/progression/not evaluated: 1/9/21/9. Tumor control (partial/stable disease): 10 pt (22%). Hematologic toxicity (grade1/2/3/4) (%) per pt: neutropenia 5/2.5/7.5/0; thrombocytopenia 15/5/2.5/5; anemia 42.5/10/52.5/0. Nonhematologic toxicity (grade 1/2/3) (%) per pt: asthenia 10/45/17.5; emesis 22.5/15/2.5.; anorexia 12.5/35/7.5; diarrhea 7.5/12.5/5; neurotoxicity 42.5/17.5/2.5; hand-foot syndrome 5/2.5/2.5. One toxic death was reported. Median time to progression: 15 weeks (95% CI 6.6-23.3). Median survival time: 19 weeks (95% CI 10.4-27.5). For pts with PS0 or 1 median overall survival was 23 weeks (95% CI 6.3-39.6) and for pts with PS2 was 8 weeks (95% CI 5.3-1.6) (p 0.004). Conclusions: Advanced pancreatic and biliar ADC have unfavorable prognosis. After first-line treatment, CAPOX shows a tolerable toxicity and some activity and it can represent an alternative on selected pretreated pts. No significant financial relationships to disclose.
348 Background: OJ is a relatively frequent complication in patients with advanced malignancies that usually causes refractory symptoms and can make chemotherapy (CT) treatment difficult. In the last years, the use of different non-surgical techniques, such as PTBD or ERCP, is increasing. Methods: From Sep-05 to Aug-10, patients with OJ due to advanced digestive cancers who underwent ERCP or PTBD were included. Baseline characteristics, acute and late complications and outcome were retrospectively collected. Jaundice resolution was recognized if bilirubin value decreased to at least grade 1, after the procedure. Overall survival (OS) was calculated from the date of the technique to the date of death or last follow-up. Results: Seventy-six consecutive patients were collected. Male/Female: 52p/24p; Mean age 63.5 y-o (range: 33-85); ECOG performance status 0/1/2/3: 1/37/27/11; Primary tumour: pancreas 30, biliary tract 18, colorectal 16, gastric 7, and gall bladder 5, and of them, 13% were unresectable locally advanced and 87% metastatic. ERCP was used in 59% of the patients and PTBD in 49% and the proportion of intrahepatic and extrahepatic causes were 1:1. Mean hospital stay was 11.3 days (95% CI 1-21). Twenty- six patients (32%) suffered a complication during the hospital stay: 9 cholangitis, 7 catheter obstruction, 2 bleeding, 2 acute pancreatitis and 6 other, and 8 died of procedure-related adverse event. After hospital discharge there were 34% infections, 17% catheter obstruction and 8% other. After the technique OJ was solved (bilirubin nadir) in 49% of the patients and 55% underwent palliative CT. Median OS was 30 weeks (95% CI: 17-42). Conclusions: PTBD and ERCP are appropriate techniques in patients with malignant OJ and can resolve an absolute contraindication for palliative CT. However, major complications are frequent and a relatively high mortality rate should be expected. Therefore an adequate patient selection is crucial to prevent adverse events. No significant financial relationships to disclose.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.