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Published on: February 12, 2017
Cisplatin-modified de Gramont in second-line therapy for pancreatic adenocarcinoma
Vutha Ky1, Monirath Hav, Frederik Berrevoet
1From the *Department of Digestive Oncology, Ghent University Hospital, Ghent, Belgium; †Calmette Hospital, Phnom Penh, Cambodia; ‡Department of Pathology, and §Department of General and Hepatobiliary Surgery, Ghent University Hospital, Ghent, Belgium; ∥Department of Gastroenterology, Maria Middelares Hospital, Ghent, Belgium; and ¶Department of Digestive Oncology, Ghent University Hospital, Ghent, Belgium.
Objectives:
In Belgium, combination chemotherapy of cisplatin and 5-fluorouracil + leucovorin (CFL) according to the modified de Gramont schedule is the treatment of choice in second line for metastatic pancreatic cancer. We retrospectively analyzed survival data in 2 Belgian centers in a nonselected population.
Methods:
Between January 2004 and October 2011, 48 patients with histologically proven recurrent or unresectable pancreatic adenocarcinoma who had received CFL as second-line treatment were identified. We retrospectively analyzed the following parameters: progression-free survival (PFS1 and PFS2) for each line (after the start of first and second line), overall survival (OS), and growth modulation index.
Results:
The median PFS1 was 5.4 months (95% confidence interval [CI], 4.1-6.6). The median PFS2 was 3.6 months (95% CI, 2-5.2). The median OS was 12 months (95% CI, 9.3-14.7). Twenty-three percent of patients had a growth modulation index >1.33.
Conclusion:
We show an OS of 12 months with gemcitabine in first-line and CFL in second-line therapy for pancreatic cancer. Sequential therapy with good OS and good quality of life may be preferred to strong upfront therapy in an incurable disease such as pancreatic cancer.
