A phase II study of oxaliplatin (O) and gemcitabine (G) first line chemotherapy in patients with advanced biliary tract cancers

Gebbia, Nicola; Verderame, Francesco; Leo, Roberto; Santangelo, Domenico; Cicero, G.; Valerio, Maria Rosaria; Arcara, Carlo; Badalamenti, Giuseppe; Fulfaro, Fabio; Carreca, Ignazio

doi:10.1200/jco.2005.23.16_suppl.4132

Cited by 15 publications

(10 citation statements)

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“…A slightly different regimen, consisting of treatment on a 28-day cycle with gemcitabine at 1,000 mg/m 2 on days 1, 8, and 15 and oxaliplatin at 100 mg/m 2 on days 1 and 15, yielded a 26% RR and 11-month median OS time and was similarly well tolerated [79]. Finally, in a reported Italian study including nine GBC patients and 15 CC patients, a 50% RR and 14-month median OS time were reported [80]. Myelosuppression and grade 1-2 peripheral neuropathy were the most significant toxicities reported among all three trials.…”

Section: Gemcitabine-based Regimensmentioning

confidence: 86%

Current Management of Gallbladder Carcinoma

et al. 2010

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Section: Gemcitabine-based Regimensmentioning

confidence: 86%

Current Management of Gallbladder Carcinoma

et al. 2010

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“…97 Despite the lack of randomized controlled trials comparing gemcitabine plus cisplatin versus GEMOX versus gemcitabine plus capecitabine, GEMOX and gemcitabine plus capecitabine may represent reasonable alternatives based on phase II studies. [110][111][112][113][114][115][116] One immediate question prompted by early promising data, as well as success in colon cancer, is to what extent EGFR-targeting antibodies will offer benefit. The early report of an improved PFS with GEMOXcetuximab compared with GEMOX alone gives this question further weight.…”

Section: Looking Forward: Improved Models Tumor Genotyping and Targmentioning

confidence: 99%

Genetics of Biliary Tract Cancers and Emerging Targeted Therapies

Hezel

2010

JCO

193

164

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A B S T R A C TBiliary tract cancers (BTC), which encompass intra-and extrahepatic cholangiocarcinomas and gallbladder carcinomas, are a genetically diverse collection of cancers. Evidence suggests distinct models of molecular and pathologic progression, and a growing body of genetics data points to a heterogeneous collection of underlying mutations in key oncogenes and tumor suppressor genes. Although tumor genetics have been used to tailor individual treatment regimens and guide clinical decision making in other cancers, these principles have not been applied in BTC. Recent clinical trials with targeted therapies seem promising, although the relationships between subsets of patients with positive responses to therapy and tumor genetics remain unexplored. Here, we summarize the molecular pathogenesis and genetics of BTCs and animal modeling and relate these to recent and ongoing clinical trials with targeted agents.

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“…The results of a phase II trial assessing the efficacy of gemcitabine combined with carboplatin in 48 cases of advanced biliary tract carcinomas (represented by 35 cholangiocarcinoma, 12 gallbladder cancer and 1 ampullary cancer) illustrated that the median PFS time, overall survival time and 6-month survival rate were 7.8 months, 10.6 months and 85.4%, respectively (17). Finally, another phase II study demonstrated that gemcitabine and oxaliplatin were associated with superior response rates (26-50%), time-to-progression (6.5-10 months) and overall survival (11-14 months) (13,16). Consideration of the aforementioned results and NCCN recommendations led to the choice of the combination of gemcitabine and oxaliplatin for treatment of the present study patient.…”

Section: Discussionmentioning

confidence: 99%

“…The rapid progression of advanced GBC provides justification for the use of adjuvant therapy, with the efficacy of chemotherapy being well established (4,(13)(14)(15)(16)(17). Single-agent and combination regimens are applied in current clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Multidisciplinary collaboration in gallbladder carcinoma treatment: A case report and literature review

et al. 2016

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Abstract. Gallbladder carcinoma (GBC) is a rare and highly aggressive disease. The diagnosis of this cancer is difficult due to its occult onset. Hence, GBC is often detected late and at an advanced stage. Although physicians and researchers are continually working to improve the treatment for advanced-stage disease, GBC is usually associated with short survival times. The present study describes a case of GBC that was first diagnosed with accompanying cholecystolithiasis at the time of cholecystectomy. Cancer relapse occurred 1.5 years after the cholecystectomy. Multidisciplinary collaboration was involved in the decision-making process for the treatment of this aggressive recurrence, and the survival time was successfully extended to 26 months. Importantly, high-grade intraepithelial neoplasia and positive margins had previously been detected post-cholecystectomy at a different institution, but were ignored. Relapse may have been preventable had the cancer been diagnosed when it was initially observed. Taken together, these findings suggest that multidisciplinary collaboration should be considered for the management of advanced GBC, whereby patients will benefit from improved survival times. Furthermore, it is recommended that samples obtained from patients undergoing cholecystectomy should more carefully analyzed for evidence of cancerous or precancerous tissues. IntroductionGallbladder carcinoma (GBC) is rarely observed in Europe and the United States; however, the incidence and mortality rates in Asian countries, including China, Japan and Korea, are much higher (5.2/100,000, 4/100,000 and 5.6/100,000 individuals, respectively) (1). The majority of patients with GBCs are diagnosed at an advanced stage, which is due, in part, to the aggressive nature of the tumor and its rapid progression. Once the cancer has reached an advanced stage, curative surgical resection can no longer be performed (2), leaving any GBC patients with a poor prognosis; the median overall survival time has been reported at only 8.2 months and the 1-year survival rate for patients with stage IV disease is estimated at 1% (3,4).The current diagnostic methods for GBC include medical imaging and bile cytological analysis. Combination of the two modalities has been shown to facilitate improved rates of diagnosis (5), but the accuracy and utility of each of these strategies are limited by their reliance on a physician's subjective evaluation and how the sampled tissue is handled prior to testing. Thus, accurate and early diagnosis remains a significant clinical challenge. Furthermore, GBC usually presents with an occult onset, therefore malignancies are commonly detected incidentally during cholecystectomy for benign diseases (6). Neglecting to further pursue these incidental findings may lead to an undiagnosed GBC, thus allowing the cancer to become more advanced and life-threatening.The treatment options for late-stage GBC treatment include enrolling in a clinical trial, gemcitabine-or fluoropyrimidine-based chemotherapy, and/or supportive ...

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A phase II study of oxaliplatin (O) and gemcitabine (G) first line chemotherapy in patients with advanced biliary tract cancers

Cited by 15 publications

References 0 publications

Current Management of Gallbladder Carcinoma

Current Management of Gallbladder Carcinoma

Genetics of Biliary Tract Cancers and Emerging Targeted Therapies

Multidisciplinary collaboration in gallbladder carcinoma treatment: A case report and literature review

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