Background
Pancreatic cancer is one of the most deadly forms of cancer. Standard treatment in metastatic disease is the quemotherapy with gemcitabine, but there is not a standard therapy for gemcitabine-refractory patients.
Purpose Assess the off-label efficacy of nab-paclitaxel, in patients who progressed on gemcitabine-based therapy, in our hospital.
Materials and Methods Observational retrospective study of pancreatic cancer patients treated with nab-paclitaxel who progressed on gemcitabine-based therapy from June 2011 to April 2012. Data were collected from clinical history, Oncofarm® and Omega3MIL® programmes. We determined: Progression free survival (PFS) and Overall Survival (OS). 12 patients (100% male) were treated with nab-paclitaxel. Eleven of them presented metastatic desease. The patients were treated with two therapies:
nab-paclitaxel 100 mg/m2 (1.8,15/28d). 5 patients received this treatment. Median age was 79.4 years (sd = 4.2 years)
Gemcitabine 1000 mg/m2 plus nab-paclitaxel 100 mg/m2 (1.8,15/28d): 7 patients received this treatment; Median age was 65.5 years (sd = 6.9 years).
Results
Median PFS was 2,8 months (95% CI, 1.5 to 4.1 months) with single agent, and 5.3 months (95% CI, 4.0 to 6.5 months) with gemcitabine plus nab-paclitaxel. The PFS in the study was 20% and 83% respectively. The OS couldn’t be determine in the nab-paclitaxel group, because there wasn’t any event during the study period. The OS with gemcitabine plus nab-paclitaxel was 66.7%.
Conclusions
It showed better clinical outcomes in the gemcitabine plus nab-paclitaxel group in PFS.
The nab-paclitaxel can be an effective second-line chemotherapy in gemcitabine resistant patients.
No conflict of interest.
Background
Vinflunine is a vinca alkaloid indicated as monotherapy for the treatment of patients with advanced or metastatic carcinoma transitional cell urothelial tract after failure of prior treatment that included platinum compounds.
Purpose
To analyse the use of vinflunine in a 600-bed hospital.
Materials and methods
Retrospective study of patients treated with vinflunine from February 2010 to April 2011. Data were collected from Oncofarm ® software, medical records of patients and dispensing program to outpatients.
Results
The authors studied 6 patients: 5 men and 1 woman, mean age: 67 (52-80) years. 4 had distant metastases (M1) at diagnosis and 2 showed no metastasis (M0). As first lines: 2 patients received carboplatin-gemcitabine scheme, with an average of 7 cycles; 2 received carboplatin-gemcitabine with an average of 7 cycles; 1 received 2 cycles of carboplatin-gemcitabine, followed by 4 cycles Gemcitabine; 1 received 5 cycles of cisplatin-gemcitabine, followed by 2 cycles of carboplatin-gemcitabine and 3 cycles of gemcitabine alone. As a second line: 3 patients received Vinflunine an average of 4 cycles; 2 received paclitaxel with an average of 4 cycles, and 1 received 8 cycles of cisplatin-gemcitabine. As a third-line: 2 patients received Vinflunine with an average of 5 cycles and 1 received 3 cycles of paclitaxel, following by a 4th line with 1 cycle of vinflunine. The use of vinflunine regimen in 2 patients was due to progression of liver carcinoma, in 2 to cerebral progression, in 1 to lung and bone progression, and progression in 1 to lung, liver and pelvic node. No patient received other subsequent treatment lines, 3 died of disease progression, 1 is currently being treated with vinflunine and 2 with symptomatic treatment.
Conclusions
Vinflunine was used in all cases correctly according to its indication, and may be an alternative for patients with advanced transitional cell urothelial tract carcinoma.
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