A phase II study of continuous-infusion 5-fluorouracil with cisplatin and epirubicin in inoperable pancreatic cancer

Evans, T.R. Jeffry; Lofts, F.; Mansi, Janine; Glees, J.P.; Dalgleish, Angus; Knight, M. J.

doi:10.1038/bjc.1996.241

Cited by 60 publications

(44 citation statements)

References 19 publications

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“…For those patients with stable disease and a serial decrease of CA19-9, this may be explained on the basis that the treatment was having an inhibitory effect on the tumour, which was insufficient to result in a response on CT. This finding is also consistent with the results of our phase II study in which patients treated with ECF who achieved either stable disease or partial response had a significantly improved median survival compared with patients who progressed during treatment (Evans et al, 1996). When comparing a reduction or plateau in the tumour marker on treatment with a serial rise of CAl9-9 concentration, no statistically significant difference in overall survival was shown, although there was a 62% prolongation of median survival in the former group.…”

Section: Discussionsupporting

confidence: 89%

“…All were evaluable for assessment of response. The results of our experience with the ECF (epirubicin, cisplatin, 5-FU) regimen in pancreatic cancer have been published previously (Evans et al, 1996). Serum samples for tumour marker assessment were obtained at baseline and before each cycle thereafter from all patients.…”

Section: Methodsmentioning

confidence: 99%

“…However, the difference in median survival of 185 days for the patients with a > 15% increase and 333 days for those with a > 15% decrease in tumour marker was significant (P = 0.001) (Wilcoxon rank test). We have previously reported our experience using ECF in inoperable pancreatic cancer (Evans et al, 1996). In this report, CT scans were used to Figure 1 Survival curves comparing the survival of patients who demonstrated a > 15% decrease in CA19-9 serum levels (closed symbols) during ECF chemotherapy with those whose CAl 9-9 levels increased by > 15% (open symbols).…”

Section: Methodsmentioning

confidence: 99%

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Are serial measurements of CA19-9 useful in predicting response to chemotherapy in patients with inoperable adenocarcinoma of the pancreas?

Gogas

Lofts²,

Evans³

et al. 1998

Br J Cancer

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Summary Thirty-nine patients with inoperable adenocarcinoma of the pancreas were studied (27 male, 12 female; median age 60 years, range 39-75 years). All patients received chemotherapy with continuous infusion 5-fluorouracil with intravenous bolus epirubicin followed by cisplatin, repeated every 21 days for a total of six cycles and were evaluable for response. Serum CAl 9-9 concentrations were obtained at baseline and before each cycle. A rise or fall in the tumour marker was defined as a greater than 15% increase or decrease in the marker on two consecutive occasions 3 weeks apart. A plateau in the tumour marker was defined as a less than 15% decrease or increase on two occasions. Changes in marker expression were compared with serial computerized tomography scanning before treatment and after the third and sixth cycle of chemotherapy. Thirty-five of 39 patients had an elevated CA19-9 (87.9%). Thirteen (36.2%) exhibited a decrease, seven (19.4%) a plateau and 16 (44.4%) patients had a progressive rise in serum CAl 9-9. The sensitivity of CAl 9-9 was 67% for predicting a partial response and 86% for progressive disease. The median survival for the 13 patients exhibiting a reduction was 333 days, for the seven patients exhibiting a plateau 253 days and for those who had a progressive rise 185 days. The difference in median survival between the group of patients with > 15% decrease and those with > 15% increase of CAl 9-9 was significant (P = 0.001). In the cohort of patients who exhibited a reduction in CAl 9-9, no tumour progression was seen, and the reduction occurred during the first three cycles of treatment. Thus, interval scanning may be avoided in this group of patients.

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Section: Discussionsupporting

confidence: 89%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Are serial measurements of CA19-9 useful in predicting response to chemotherapy in patients with inoperable adenocarcinoma of the pancreas?

Gogas

Lofts²,

Evans³

et al. 1998

Br J Cancer

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“…Many oncology patients require easy vascular access for delivery of chemotherapy, other intravenous treatments such as fluids, blood products and parenteral nutrition solutions [1,2]. They have great advantages over tunnelled catheters in terms of low infection rates, long patient life, patient comfort and ambulatory treatment [3][4][5].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Implantable Central Venous Ports:Subclavian Versus Juguler Access

Karamustafaoğlu¹,

Yağcı²,

Koçal³

et al. 2013

Ann Clin Anal Med

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Anahtar KelimelerSantral Venöz Girişim, İmplante Edilebilir Port, Eksternal Juguler Ven, Subklavyen Ven. AbstractAim: Today, implantable central venous ports (ICVP) are increasingly used in oncology patients and provide easy vascular access for delivery of chemotherapy, other intravenous treatments, as fluids, blood products and parenteral nutrition solutions. In this study, we present our experience and comparison of efficacy and incidence of complications between subclavian versus jugular access in oncology patients and provide easy vascular access for delivery of chemotherapy. Material and Method: Three hundred ten implantable central venous ports (ICVP) were implanted via the subclavian vein (SV) in 145 patients (66 men, 79 women) with average age of 56.55 (18-86) and were implanted via the external jugular vein (EJV) in 165 patients (75 men, 90 women) with average age of 56

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“…Objective response rates remain low with most single-agent chemotherapy including 21 -26% with 5FU (Carter, 1975;Moertel, 1976), 26% with ifosfamide (Bernard et al, 1986), 22% with epirubicin (Wils et al, 1985) and 21% with cisplatin (Wils et al, 1993). Furthermore, the results of combination chemotherapy have also been disappointing with objective response rates of only 26% using 5FU with BCNU (Kovach et al, 1974), 10% with 5FU and mitomycin C (Buroker et al, 1979), 14% with FAM (5FU, doxorubicin, mitomycin C) (Oster et al, 1986), and 17% with continuous infusional 5FU administered with epirubucin and cisplatin (Evans et al, 1996). More recently, gemcitabine was observed to have promising activity in phase II trials (Casper et al, 1994;Rothenberg et al, 1996).…”

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confidence: 99%

A phase II trial of the vitamin D analogue Seocalcitol (EB1089) in patients with inoperable pancreatic cancer

et al. 2002

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Inoperable cancer of the exocrine pancreas responds poorly to most conventional anti-cancer agents, and new agents are required to palliate this disease. Seocalcitol (EB1089), a vitamin D analogue, can inhibit growth, induce differentiation and induce apoptosis of cancer cell lines in vitro and can also inhibit growth of pancreatic cancer xenografts in vivo . Thirty-six patients with advanced pancreatic cancer received once daily oral treatment with seocalcitol with dose escalation every 2 weeks until hypercalcaemia occurred, following which patients continued with maintenance therapy. The most frequent toxicity was the anticipated dose-dependent hypercalcaemia, with most patients tolerating a dose of 10–15 μg per day in chronic administration. Fourteen patients completed at least 8 weeks of treatment and were evaluable for efficacy, whereas 22 patients were withdrawn prior to completing 8 weeks' treatment and in 20 of these patients withdrawal was due to clinical deterioration as a result of disease progression. No objective responses were observed, with five of 14 patients having stable disease in whom the duration of stable disease was 82–532 days (median=168 days). The time to treatment failure ( n =36) ranged from 22 to 847 days, and with a median survival of approximately 100 days. Seocalcitol is well tolerated in pancreatic cancer but has no objective anti-tumour activity in advanced disease. Further studies are necessary to determine if this agent has any cytostatic activity in this malignancy in minimal disease states. British Journal of Cancer (2002) 86 , 680–685. DOI: 10.1038/sj/bjc/6600162 www.bjcancer.com © 2002 Cancer Research UK

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A phase II study of continuous-infusion 5-fluorouracil with cisplatin and epirubicin in inoperable pancreatic cancer

Cited by 60 publications

References 19 publications

Are serial measurements of CA19-9 useful in predicting response to chemotherapy in patients with inoperable adenocarcinoma of the pancreas?

Are serial measurements of CA19-9 useful in predicting response to chemotherapy in patients with inoperable adenocarcinoma of the pancreas?

Comparison of Implantable Central Venous Ports:Subclavian Versus Juguler Access

A phase II trial of the vitamin D analogue Seocalcitol (EB1089) in patients with inoperable pancreatic cancer

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