Department of Medical Oncology, University General Hospital of Alexandroupolis, Dragana, 68100 Alexandroupolis, Thrace, Greece.
Cancer Chemother Pharmacol. 2012 Feb;69(2):477-84. doi: 10.1007/s00280-011-1717-6. Epub 2011 Aug 20.
To evaluate the activity and tolerance of gemcitabine in combination with docetaxel and capecitabine in previously untreated patients with advanced pancreatic cancer.
Chemotherapy-naïve patients with locally advanced or metastatic pancreatic cancer were treated with gemcitabine (1,500 mg/m(2) on days 1 and 15), docetaxel (50 mg/m(2) on days 1 and 15) and capecitabine (2,250 mg/m(2), orally in two daily divided doses, on days 1-7 and 15-21). All three drugs were administered in 4-week cycles, in an initial prospective plan of six cycles. The primary end-point was response rate.
Forty patients were enrolled in the study. At the time of enrollment, 40% of patients had locally advanced and 60% metastatic disease. All patients were evaluable for response and toxicity. On an intent-to-treat analysis, the overall response and disease control rates were 40 and 80%, respectively. The median progression-free survival was 6.0 months, and the median overall survival was 9.0 months. Major grade 3/4 toxicities were neutropenia (17.5%), diarrhea (10%) and hand-foot syndrome (7.5%). There was no treatment-related death.
The combination of gemcitabine with docetaxel and capecitabine is feasible and exhibits satisfactory degree of activity in patients with advanced pancreatic cancer, deserving further exploration.
评估吉西他滨联合多西紫杉醇和卡培他滨治疗未经治疗的晚期胰腺癌患者的疗效和耐受性。
对局部晚期或转移性胰腺癌的化疗初治患者给予吉西他滨(第 1 天和第 15 天 1,500mg/m²)、多西紫杉醇(第 1 天和第 15 天 50mg/m²)和卡培他滨(第 1-7 天和第 15-21 天 2,250mg/m²,分两次每日口服)。所有三种药物均以 4 周为一个周期,最初按 6 个周期的前瞻性方案给药。主要终点为缓解率。
共有 40 例患者入组研究。入组时,40%的患者为局部晚期,60%的患者为转移性疾病。所有患者均对疗效和毒性进行了评估。在意向治疗分析中,总缓解率和疾病控制率分别为 40%和 80%。中位无进展生存期为 6.0 个月,中位总生存期为 9.0 个月。主要的 3/4 级毒性为中性粒细胞减少(17.5%)、腹泻(10%)和手足综合征(7.5%)。无治疗相关死亡。
吉西他滨联合多西紫杉醇和卡培他滨在晚期胰腺癌患者中是可行的,且具有令人满意的疗效,值得进一步探索。