Gemcitabine alone or with cisplatin for the treatment of patients with locally advanced and/or metastatic pancreatic carcinoma

Colucci, Giuseppe; Giuliani, Francesco; Gebbia, Vittorio; Biglietto, M.; Rabitti, Piergiorgio; Uomo, Generoso; Cigolari, S.; Testa, Antonio; Maiello, Evaristo; Lopez, Massimo

doi:10.1002/cncr.10323.abs

Cited by 67 publications

(56 citation statements)

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“…Two clinical studies suggested that GemCis chemotherapy was associated with a prolongation of PFS, but only one trial [11] showed a significantly longer of PFS (5 vs 2 months; P = 0.048). In our study, PFS was more favorable in the GemCis arm than Gem alone, but the trend did not reach statistical significance (8.9 vs 6.0 months, p=0.08).…”

Section: Discussionmentioning

confidence: 99%

“…Some clinical studies suggest that the combination of Gem and Cis may improve objective response rates (ORR), PFS, and OS [11,15,-17]. Previous studies had shown that Gem induced a clinical response of 42% to 48% [8,11,18], while the GemCis consistently increased CR to a range of 55% to 70% [8,11,[15][16][17]. These findings were similarly found in our study was a clinical response of 69% in the GemCis arm, whereas Gem arm was 49.7%(p=0.001).…”

Section: Discussionmentioning

confidence: 99%

“…To improve therapeutic efficacy, numerous clinical studies randomized trials have investigated gemcitabine plus platinum analog combination regimens in patients with advanced pancreatic adenocarcinoma [8][9][10][11]13,14]. Some clinical studies suggest that the combination of Gem and Cis may improve objective response rates (ORR), PFS, and OS [11,15,-17].…”

Section: Discussionmentioning

confidence: 99%

“…The responses to chemotherapy were measured according to RECIST [11]. A complete response (CR) was defined as disappearance of all target lesions, no new lesions and normalization of the tumor markers for at least 4 weeks.…”

Section: Methodsmentioning

confidence: 99%

“…Several randomized Phase II and III trials suggest that GemCis response rates were higher Gem alone, however the trials were not enough powered to indicate a statistically significant prolongation of survival in patients with advanced pancreatic adenocarcinoma [7][8][9][10][11][12].…”

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confidence: 99%

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Gemcitabine Alone versus combination of Gemcitabine and Cisplatin for the Treatment of Patients with Locally Advanced and/or Metastatic Pancreatic Carcinoma: A Retrospective Analysis of multicenter study (Anatolian Society of Medical Oncology)

İnal

Ft²,

Algın³

et al. 2012

neo

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Gemcitabine Alone versus combination of Gemcitabine and Cisplatin for the Treatment of Patients with Locally Advanced and/or Metastatic Pancreatic Carcinoma: A Retrospective Analysis of multicenter study (Anatolian Society of Medical Oncology)

İnal

Ft²,

Algın³

et al. 2012

neo

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Management of isolated recurrence after surgery for pancreatic adenocarcinoma

Kim

Song

Lee

et al. 2019

British Journal of Surgery

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Background: Recurrence of pancreatic cancer after primary pancreatectomy occurs in the vast majority of patients. The role of surgical treatment for recurrent pancreatic cancer is not well established. Methods: Patients who underwent primary pancreatectomy with curative intent from 2000 to 2014 at a single large-volume centre were evaluated retrospectively. CT or PET was used to select patients with an isolated recurrence. The clinicopathological features and survival outcomes were compared according to treatment modalities. Results: Of the 1610 patients with pancreatic cancer who underwent resection, 1346 (83⋅6 per cent) were diagnosed with recurrent pancreatic cancer. Recurrence was locoregional in 366 patients (27⋅2 per cent), distant multifocal in 251 (18⋅6 per cent), distant isolated in 188 (14⋅0 per cent), locoregional plus distant in 153 (11⋅4 per cent) and peritoneal seeding in 388 (28⋅8 per cent). Of the 1346 patients with recurrence, 197 (14⋅6 per cent) had isolated recurrence; of these, 48 (24⋅4 per cent of all isolated recurrences; 3⋅6 per cent of all recurrences) underwent resection. Median survival of the 197 patients after diagnosis of isolated recurrence was 14⋅7 months; it was longer in patients who underwent surgical resection than among those treated non-surgically (23⋅5 versus 12⋅0 months; P = 0⋅014). Multivariable analysis showed that chemotherapy and resection for recurrence were associated with better prognosis. Median survival after recurrence was longest in the 23 patients with isolated pulmonary recurrence (33⋅3 months). Survival after recurrence was better in patients who underwent resection of isolated recurrence in the remnant pancreas (median 28⋅0 versus 12⋅0 months, P = 0⋅010) and lung (median 36⋅5 versus 9⋅5 months; P = 0⋅010) than in those who did not undergo resection.Conclusion: Surgical resection may be considered an option for treatment of patients with isolated recurrent pancreatic cancer.

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Gemcitabine‐based combinations for inoperable pancreatic cancer: Have we made real progress?

Bria

Milella

Gelibter³

et al. 2007

Cancer

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BACKGROUND.Several attempts have been made at improving the efficacy of gemcitabine in advanced pancreatic cancer by combining it with other chemotherapeutic or molecularly targeted agents. However, randomized trials have produced conflicting results.METHODS.All prospective, randomized, phase 3 trials that compared single‐agent gemcitabine with gemcitabine‐based combinations were considered eligible for the current analysis. A literature‐based meta‐analysis was performed, event‐based relative risk ratios with 95% confidence intervals were derived through both a fixed‐effect model approach and a random‐effect model approach, and overall survival (OS) was explored as the primary endpoint. To estimate the magnitude of the eventual benefit, absolute differences and the number of patients needed to treat (NNT) for 1 patient to benefit were calculated. A sensitivity analysis for OS was performed according to the type of agent used in combination with gemcitabine.RESULTS.Twenty trials that involved 6296 patients were identified. No significant differences in the primary endpoint were observed in the overall population or in the sensitivity analysis. Conversely, a significant advantage was evident with regard to both progression‐free survival (PFS) and the overall response rate (ORR) in the overall population, with an absolute benefit of 2.6% (NTT = 39 patients) and 3.0% (NNT = 33 patients). Platinum combinations led to the greatest absolute benefits for PFS and ORR compared with single‐agent gemcitabine (10% and 6.5%, respectively), but this did not result in an OS benefit. Improvement in PFS, but not in the ORR, was correlated with an improvement in OS.CONCLUSIONS.Single‐agent gemcitabine remains the standard of care for patients with advanced pancreatic cancer. However, platinum/gemcitabine combinations appeared to improve PFS and the ORR and, thus, may be considered in selected patients. Cancer 2007. © 2007 American Cancer Society.

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Gemcitabine alone or with cisplatin for the treatment of patients with locally advanced and/or metastatic pancreatic carcinoma

Cited by 67 publications

References 0 publications

Gemcitabine Alone versus combination of Gemcitabine and Cisplatin for the Treatment of Patients with Locally Advanced and/or Metastatic Pancreatic Carcinoma: A Retrospective Analysis of multicenter study (Anatolian Society of Medical Oncology)

Gemcitabine Alone versus combination of Gemcitabine and Cisplatin for the Treatment of Patients with Locally Advanced and/or Metastatic Pancreatic Carcinoma: A Retrospective Analysis of multicenter study (Anatolian Society of Medical Oncology)

Management of isolated recurrence after surgery for pancreatic adenocarcinoma

Gemcitabine‐based combinations for inoperable pancreatic cancer: Have we made real progress?

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Gemcitabine alone or with cisplatin for the treatment of patients with locally advanced and/or metastatic pancreatic carcinoma

Cited by 67 publications

References 0 publications

Gemcitabine Alone versus combination of Gemcitabine and Cisplatin for the Treatment of Patients with Locally Advanced and/or Metastatic Pancreatic Carcinoma: A Retrospective Analysis of multicenter study (Anatolian Society of Medical Oncology)

Gemcitabine Alone versus combination of Gemcitabine and Cisplatin for the Treatment of Patients with Locally Advanced and/or Metastatic Pancreatic Carcinoma: A Retrospective Analysis of multicenter study (Anatolian Society of Medical Oncology)

Management of isolated recurrence after surgery for pancreatic adenocarcinoma

Gemcitabine‐based combinations for inoperable pancreatic cancer: Have we made real progress?

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Product

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Gemcitabine Alone versus combination of Gemcitabine and Cisplatin for the Treatment of Patients with Locally Advanced and/or Metastatic Pancreatic Carcinoma: A Retrospective Analysis of multicenter study (Anatolian Society of Medical Oncology)

Gemcitabine Alone versus combination of Gemcitabine and Cisplatin for the Treatment of Patients with Locally Advanced and/or Metastatic Pancreatic Carcinoma: A Retrospective Analysis of multicenter study (Anatolian Society of Medical Oncology)