A multicenter analysis of GTX chemotherapy in patients with locally advanced and metastatic pancreatic adenocarcinoma

Jesus-Acosta, Ana De; Oliver, George R.; Blackford, Amanda L.; Kinsman, Katharine; Flores, Edna I.; Wilfong, Lalan S.; Li, Zheng; Donehower, Ross C.; Cosgrove, David; Laheru, Daniel A.; Le, Dung T.; Chung, Ki Young; Díaz, Luis A.

doi:10.1007/s00280-011-1704-y

Cited by 39 publications

(25 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A retrospective study of 154 patients with advanced pancreatic cancer treated with GTX reported a response rate of 11% and median survival of 11.6 months (in stage IV patients; ref. 46). The rate of grade 3 or worse hematologic toxicities was 41%.…”

Section: Docetaxel-in the Context Of "Gtx"mentioning

confidence: 88%

The Winning Formulation: The Development of Paclitaxel in Pancreatic Cancer

Wee

Hidalgo

2013

Clinical Cancer Research

View full text Add to dashboard Cite

Paclitaxel has wide application in anticancer therapy but was never considered an efficacious agent in pancreatic cancer. A review of the experience with the Cremaphor formulation hinted at paclitaxel's activity in pancreatic cancer, but the early development was hampered by significant toxicities such as neutropenia and infection at clinically tolerable doses. However, such efficacy was confirmed in the recently completed phase III Metastatic Pancreatic Adenocarcinoma Clinical Trial (MPACT), in which the addition of nabpaclitaxel to gemcitabine significantly improved the survival of patients with metastatic pancreatic cancer. Several other Cremaphor-free formulations of paclitaxel had also been evaluated in pancreatic cancer, and the reasons for the success of the albumin nanoparticulate are examined here. In the era of biologic and molecularly targeted agents, the success of nab-paclitaxel in recalcitrant pancreatic cancer is a timely reminder of the importance and relevance of pharmacology and novel drug delivery technology in the development of anticancer drugs.

show abstract

Section: Docetaxel-in the Context Of "Gtx"mentioning

confidence: 88%

The Winning Formulation: The Development of Paclitaxel in Pancreatic Cancer

Wee

Hidalgo

2013

Clinical Cancer Research

View full text Add to dashboard Cite

show abstract

“…Until recently, the standard of care for metastatic disease had been the nucleoside analogue, gemcitabine [1]. However, this convention has been challenged by recent studies showing significant survival advantage with FOLFIRINOX (5-FU, irinotecan, and oxaliplatin) [2] and other combination chemotherapies [3–5]. …”

Section: Introductionmentioning

confidence: 99%

Family history as a marker of platinum sensitivity in pancreatic adenocarcinoma

Fogelman

Sugar

Oliver

et al. 2015

Cancer Chemother Pharmacol

Self Cite

View full text Add to dashboard Cite

Purpose Metastatic pancreatic adenocarcinoma is considered a uniformly fatal disease with a median survival of 1 year with modern chemotherapy. While a subset of patients achieve prolonged survival, few of the factors that define this group of patients are known. Methods For the determination of overall survival (OS), 549 patients with histologically confirmed metastatic pancreatic adenocarcinoma were evaluated. Emphasis was placed on treatment history and family history of breast, ovarian, and pancreatic cancers. To ensure a uniform metastatic population, patients treated with prior locoregional therapies (i.e., surgery or radiotherapy) were excluded as were patients with a prior history of stage I–III disease. Results Patients with family history or pedigree history of cancer had superior OS. This was especially true in patients with three or more relatives with either breast, ovarian, or pancreatic cancers [hazard ratio (HR) 0.49, 95 % confidence interval (CI) 0.30–0.80, p = 0.003]. First-line platinum chemotherapy was associated with a poor survival (hazard ratio for death 1.74, 95 % CI 1.12–2.71, p = 0.01) for patients without a family history of these cancers but not for those without such a history (p = 0.31). In fact, as the number of relatives with these cancers increased, the OS survival improved for individuals receiving first-line platinum therapy (HR 0.76, 95 % CI 0.65–0.89, p = 0.0004), which was not the case for those receiving other therapies (p = 0.98). Conclusions Treatment with platinum chemotherapy in patients with a family history of breast, ovarian, or pancreatic cancers was associated with a longer survival, whereas platinum use in patients without such a family history of cancer was associated with poor survival. These findings suggest that family history may serve as a predictive marker for platinum use in patients with metastatic pancreatic adenocarcinoma.

show abstract

“…None of the patients had a radiologic response to treatment. The second retrospective review by De Jesus-Acosta et al included 154 patients treated with GTX in any line of therapy for metastatic disease, with 51% of patients receiving first-line GTX 16. Patients who were chemotherapy-naïve demonstrated a median overall survival of 11.6 months, while those who received it as a second line or greater had a median overall survival of 5.7 months.…”

Section: Introductionmentioning

confidence: 99%

Profile and potential of ixabepilone in the treatment of pancreatic cancer

Smaglo¹,

Pishvaian²

2014

DDDT

View full text Add to dashboard Cite

The management of metastatic pancreatic adenocarcinoma is a challenge for medical oncologists because of both the aggressive nature of the disease and the relative paucity of effective systemic treatments with activity against this type of tumor. In the effort to discover new agents and combinations that may augment the therapeutic arsenal available for the management of this cancer, early phase clinical trials have been performed using ixabepilone, an epothilone B analog, with promising results. Targeting the microtubule system with certain taxanes in the management of pancreatic adenocarcinoma has been validated; ixabepilone also targets the microtubule system, interfering with it in an alternate manner from the taxane mechanism. Ixabepilone has demonstrated activity in cancers that have become taxane-resistant as well as those that never had any demonstrable taxane susceptibility. The available data for the use of ixabepilone in the management of pancreatic adenocarcinoma are limited but promising. Single-arm studies have demonstrated both clinical efficacy and tolerable toxicity for the use of ixabepilone as monotherapy. The trial data available for ixabepilone used as a part of combination therapy are similar: it has been paired with chemotherapy (carboplatin, irinotecan) and biologic therapy (dasatinib, sunitinib) at the Phase I level to treat solid tumors in general, again with tolerable side effects and a suggestion of benefit. A single Phase II study has evaluated combination therapy with ixabepilone in the management of patients with pancreatic cancer, pairing it with cetuximab with clinical benefit. Although these trials are promising with regard to addition of ixabepilone to the slim armamentarium for management of pancreatic cancer, further work is still to be done. Importantly, this work bears the burden of not only validating the clinical benefit of ixabepilone, but also of determining whether this benefit is enhanced in any way by combination therapy, and where ixabepilone fits in the sequence of management for patients with metastatic pancreatic cancer.

show abstract

A multicenter analysis of GTX chemotherapy in patients with locally advanced and metastatic pancreatic adenocarcinoma

Cited by 39 publications

References 25 publications

The Winning Formulation: The Development of Paclitaxel in Pancreatic Cancer

The Winning Formulation: The Development of Paclitaxel in Pancreatic Cancer

Family history as a marker of platinum sensitivity in pancreatic adenocarcinoma

Profile and potential of ixabepilone in the treatment of pancreatic cancer

Contact Info

Product

Resources

About