A phase II study of gemcitabine combined with radiation therapy in patients with localized unresectable pancreatic cancer

Epelbaum, Ron; Rosenblatt, E.; Kuten, Abraham

doi:10.1016/s0360-3016(00)80241-2

Cited by 14 publications

(27 citation statements)

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“…Moreover, it is possible that patients receiving FOLFIRINOX and subsequent chemoradiation may have had a response significant enough to justify surgical exploration and subsequent resection, a "conversion" scenario, which has been observed in several uncontrolled series [14,15]; however, the requirement for chemoradiation in theconversionscenarioisunproven.Forpatientswhoarestillunable to undergo resection after completing chemotherapy and subsequent chemoradiation and for those patients who are fortunate enough to undergo resection but who subsequently recur, the use of chemoradiation could make eventual return to systemic chemotherapy more challenging. This concern is substantiated in small studies using chemotherapy after initial chemoradiation [16,17].…”

Section: By Jason E Farismentioning

confidence: 99%

The Controversial Role of Chemoradiation for Patients With Locally Advanced Pancreatic Cancer

Faris

2013

The Oncologist

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A 58-year-old woman presents with 2 months of back discomfort. Abdominal computed tomography reveals a 5-cm mass in the body of the pancreas with no obvious metastatic disease. The tumor surrounds the celiac artery, and the superior mesenteric vein is obliterated. Endoscopic ultrasound-guided fine needle aspiration shows adenocarcinoma, positive cytokeratin 7, positive carbohydrate antigen 19 -9, and negative cytokeratin 20. She receives 4 months of FOLFIRINOX, with resolution of symptoms and a reduction in the size of the tumor, but the tumor continues to demonstrate superior mesenteric artery encasement and superior mesenteric vein obliteration. Should this patient continue chemotherapy or initiate chemoradiation at this juncture? The Oncologist 2013;18:981-985

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Section: By Jason E Farismentioning

confidence: 99%

The Controversial Role of Chemoradiation for Patients With Locally Advanced Pancreatic Cancer

Faris

2013

The Oncologist

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“…[40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57] Five studies combined gemcitabine with docetaxel, [58][59][60][61][62] four with platinum compounds, 63-66 two with mitomycin C (MMC), 67,68 and seven with other drugs in more complex combinations. [69][70][71][72][73][74][75] In addition, four examined the role of gemcitabine plus radiation, [76][77][78][79] and two used regimens in which gemcitabine was combined with hormonal treatments. 80,81 The characteristics of all studies are given in appendix 3 (Tables 3-12).…”

Section: Other Identified Studiesmentioning

confidence: 99%

“…Only four Phase II studies [76][77][78][79] were identified that examined the role of gemcitabine in chemoradiation. All were published in abstract form.…”

Section: Gemcitabine In Chemoradiationmentioning

confidence: 99%

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A rapid and systematic review of the clinical effectiveness and cost-effectiveness of gemcitabine for the treatment of pancreatic cancer

Ward

Morris²,

Bansback³

et al. 2001

Health Technol Assess

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“…Ten out of 20 patients who achieved a clinical benefit response and tumour stabilisation or response following a 7-week induction with gemcitabine (1000 mg/m 2 ) were given EBRT (three-field administration of 50.4 Gy in fractions with gemcitabine (400 mg/m 2 ) for three out of four weeks followed by maintenance gemcitabine (1000 mg/m 2 ). 147 Four patients had a partial response and two underwent pancreatectomy, one with negative margins, the other with no histological evidence of malignancy. The overall median survival was 8 months and the 1-year survival was 30%.…”

mentioning

confidence: 98%

Chemotherapy for pancreatic cancer

Shore

Raraty

Ghaneh

et al. 2003

Aliment Pharmacol Ther

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SUMMARYPancreatic cancer is a common, highly lethal disease that is rising in incidence. Chemotherapy based on 5-fluorouracil (5-FU) has been shown to prolong survival in advanced pancreatic cancer. Gemcitabine improves major symptoms and survival outcomes compared with bolus 5-FU. Many novel small molecules are being widely and actively researched. These compounds are based on classical mechanisms of action as well as biological therapies targeting novel cellular survival pathways, and include fluoropyrimidines, nucleoside cytidine analogues, platinum analogues, topoisomeraseinhibitors, antimicrotubule agents, proteasome inhibitors, vitamin D analogues, arachidonic acid pathway inhibitors, histone deacytylator inhibitors, farnesyltransferase inhibitors and epidermal growth factor receptor therapies.Adjuvant chemotherapy has also demonstrated the best survival outcomes following resection compared to other adjuvant or neo-adjuvant strategies such as radiation-based treatments. These benefits are superimposed on the dramatic increase in resectability rates and reduction in post-operative mortality achieved by centralisation of treatment in high-volume speciality centres. Newer 'small-molecule' drugs as well as the latest 'large-molecule' biological agents hold considerable promise for the future. Real advances are anticipated over the next five years but are dependent on large randomised controlled trials for success.

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A phase II study of gemcitabine combined with radiation therapy in patients with localized unresectable pancreatic cancer

Cited by 14 publications

References 0 publications

The Controversial Role of Chemoradiation for Patients With Locally Advanced Pancreatic Cancer

The Controversial Role of Chemoradiation for Patients With Locally Advanced Pancreatic Cancer

A rapid and systematic review of the clinical effectiveness and cost-effectiveness of gemcitabine for the treatment of pancreatic cancer

Chemotherapy for pancreatic cancer

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