The Role of Gemcitabine in the Treatment of Cholangiocarcinoma and Gallbladder Cancer: A Systematic Review

Dingle, Brian; Rumble, R. Bryan; Brouwers, Melissa

doi:10.1155/2005/565479

Cited by 54 publications

(32 citation statements)

References 11 publications

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“…However, combination chemotherapy resulted in a marginally better response rate (CR þ PR: 27.8 vs 22.6%), and superior tumour control rate (CR þ PR þ SD: 75.0 vs 58.0%), broadly in line with that seen in previous studies (Dingle et al, 2005). Both treatment arms were well tolerated, although patients who received doublet therapy showed a significant increase in lethargy (28.6 vs 9.1%); the effect of this finding on the quality of life was not explored in this study.…”

Section: Discussionsupporting

confidence: 89%

Gemcitabine alone or in combination with cisplatin in patients with advanced or metastatic cholangiocarcinomas or other biliary tract tumours: a multicentre randomised phase II study – The UK ABC-01 Study

et al. 2009

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We assessed the activity of gemcitabine (G) and cisplatin/gemcitabine (C/G) in patients with locally advanced (LA) or metastatic (M) (advanced) biliary cancers (ABC) for whom there is no standard chemotherapy. METHODS: Patients, aged X18 years, with pathologically confirmed ABC, Karnofsky performance (KP) X60, and adequate haematological, hepatic and renal function were randomised to G 1000 mg m À2 on D1, 8, 15 q28d (Arm A) or C 25 mg m À2 followed by G 1000 mg m À2 D1, 8 q21d (Arm B) for up to 6 months or disease progression. RESULTS: In total, 86 patients (A/B, n ¼ 44/42) were randomised between February 2002 and May 2004. Median age (64/62.5 years), KP, primary tumour site, earlier surgery, indwelling biliary stent and disease stage (LA: 25/38%) are comparable between treatment arms. Grade 3 -4 toxicity included (A/B, % patients) anaemia (4.5/2.4), leukopenia (6.8/4.8), neutropenia (13.6/14.3), thrombocytopenia (9.1/11.9), lethargy (9.1/28.6), nausea/vomiting (0/7.1) and anorexia (2.3/4.8). Responses (WHO criteria, % of evaluable patients: A n ¼ 31 vs B n ¼ 36): no CRs; PR 22.6 vs 27.8%; SD 35.5 vs 47.1% for a tumour control rate (CR þ PR þ SD) of 58.0 vs 75.0%. The median TTP and 6-month progression-free survival (PFS) (the primary end point) were greater in the C/G arm (4.0 vs 8.0 months and 45.5 vs 57.1% in arms A and B, respectively). CONCLUSION: Both regimens seem active in ABC. C/G is associated with an improved tumour control rate, TTP and 6-month PFS. The study has been extended (ABC-02 study) and powered to determine the effect on overall survival and the quality of life.

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Section: Discussionsupporting

confidence: 89%

Gemcitabine alone or in combination with cisplatin in patients with advanced or metastatic cholangiocarcinomas or other biliary tract tumours: a multicentre randomised phase II study – The UK ABC-01 Study

et al. 2009

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“…Gemcitabine (GEM), which is phosphorylated by deoxycytidine kinase to interfere DNA synthesis after endocytosis[144, 145], is frequently used as the first-line therapy in clinical treatment for pancreatic cancer. However, the rapid emergence of drug resistance significantly limited the application of GEM.…”

Section: Mechanism Underlying Combination Chemotherapymentioning

confidence: 99%

Recent advances of cocktail chemotherapy by combination drug delivery systems

Sun

Wang

et al. 2016

Advanced Drug Delivery Reviews

533

336

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Combination chemotherapy is widely exploited for enhanced cancer treatment in clinic. However, the traditional cocktail administration of combination regimens often suffers from varying pharmacokinetics among different drugs. The emergence of nanotechnology offers an unparalleled opportunity for developing advanced combination drug delivery strategies with the ability to encapsulate various drugs simultaneously and unify the pharmacokinetics of each drug. This review surveys the most recent advances in combination delivery of multiple small molecule chemotherapeutics using nanocarriers. The mechanisms underlying combination chemotherapy, including the synergistic, additive and potentiation effects, are also discussed with typical examples. We further highlight the sequential and site-specific co-delivery strategies, which provide new guidelines for development of programmable combination drug delivery systems. Clinical outlook and challenges are also discussed in the end.

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“…A systemic review of 13 single-arm phase II trials confirmed the benefits of gemcitabine in combination with a fluoropyrimidine (5-FU or capecitabine) for ABC (20). We have previously reported that gem-cap is beneficial for ABC with an overall response rate of 58%, a PFS of 9.0 mo and median OS of 14 mo (12).…”

Section: Discussionmentioning

confidence: 92%

Gemcitabine and capecitabine for advanced biliary cancer

Gabriel

Gandhi

Attwood

et al. 2017

J. Gastrointest. Oncol.

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Background: Gemcitabine with capecitabine (gem-cap) is an established regimen for advanced biliary cancer (ABC) supported by our previously reported phase II trial. Here, we provide our updated experience. (69/129) experienced a grade 3/4 toxicity. The most common (35.7%) was a hematologic toxicity (neutropenia or thrombocytopenia) followed by infection (25.6%). Conclusions: Gem-cap provides similar survival outcomes to gemcitabine/cisplatin based on historical comparison to the ABC-2 trial (median PFS =8.0 mo and OS =11.7 mo). Gem-cap may offer the advantage of fewer adverse events compared to the levels reported in ABC-2 (grade 3/4 events 70.7%).

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The Role of Gemcitabine in the Treatment of Cholangiocarcinoma and Gallbladder Cancer: A Systematic Review

Cited by 54 publications

References 11 publications

Gemcitabine alone or in combination with cisplatin in patients with advanced or metastatic cholangiocarcinomas or other biliary tract tumours: a multicentre randomised phase II study – The UK ABC-01 Study

Gemcitabine alone or in combination with cisplatin in patients with advanced or metastatic cholangiocarcinomas or other biliary tract tumours: a multicentre randomised phase II study – The UK ABC-01 Study

Recent advances of cocktail chemotherapy by combination drug delivery systems

Gemcitabine and capecitabine for advanced biliary cancer

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