A phase II trial of piroxantrone in adenocarcinoma of the pancreas

Jenkins, Terry R.; Tangen, Catherine M.; Macdonald, John S.; Weiss, Geoffrey R.; Chapman, Robert A.; Hantel, Alexander

doi:10.1007/bf00874432

Cited by 10 publications

(2 citation statements)

References 3 publications

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“…However, all such trials to date have met with very limited success. The majority of single agents evaluated have been found to be either ineffective or to lead to significant levels of toxicity which makes their routine use of limited value 88 –107 . A selection of the results obtained in these trials is provided in Table 2.…”

Section: The Role Of Chemotherapymentioning

confidence: 99%

“…91 Merbarone Concluded to be ineffective Moore 82 5FU ± rhGM-CSF No survival or quality of life advantage over 5-FU alone Mahjoubi 92 Pirarubicin Concluded to be ineffective Leichmann 94 Amona®de Severe toxicity and ineffective Ebert 99 Octreotide Low dose: median survival 3 months (ineffective) High dose: median survival 6 months. No signi®cant side-effects and improved quality of life Friess 103 Octreotide Concluded to be ineffective at low dose Casper 104 Edatrexate Minor therapeutic activityÐineffective as a single agent Jenkins 106 Piroxantrone Signi®cant toxicity and ineffective Kajanti 107 Oral carmofur Median survival 8 months (3% partial response, 23% stable disease).…”

Section: The Role Of Chemotherapymentioning

confidence: 99%

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Review article: current treatment and optimal patient management in pancreatic cancer

Haycox

Lombard

Neoptolemos

et al. 1998

Aliment Pharmacol Ther

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This review analyses the current state of knowledge and understanding concerning the optimum treatment and therapeutic management of patients who suffer from pancreatic cancer. It outlines recent advances in scientific understanding and assesses their potential future value to clinicians in confronting this disease. Despite a significant expansion in scientific knowledge relating to factors underlying the early development of pancreatic carcinoma, the clinician continues to be restricted to a severely limited therapeutic armoury for this disease. Local therapies (surgery and radiation) are inevitably of limited value in the face of a disease that is normally encountered at a stage where metastasis is already highly developed. Despite such limitations, however, surgery performed in specialist units may be of value for 10-20% of patients, with a 5-year survival rate in such units of between 10 and 24%. This may be improved even further by appropriate use of adjuvant treatment. The advanced stage of the disease when normally encountered emphasizes the potential value of systemic treatment in this therapeutic area. Unfortunately systemic treatment (chemotherapy) has been found to be ineffective to date in significantly extending survival, with a low rate and duration of remission being identified in most trials. The challenge for both the health service and the pharmaceutical industry is to harness recent and future developments in scientific knowledge to the practical benefit of clinicians. Where cure is possible it should be vigorously pursued; where it is not, in this field above all others, clinicians have a duty of care. To achieve this it is necessary to abandon the therapeutic nihilism that has characterized the attitudes of clinicians towards this disease in the past. It is time that such nihilism was replaced by a recognition of the challenges and the opportunities available to clinicians in enhancing the quantity and quality of life available to patients. The dictum of 'curing whenever possible but caring always' should be the future therapeutic philosophy used to guide clinicians in this important and rapidly changing therapeutic area.

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Section: The Role Of Chemotherapymentioning

confidence: 99%

Section: The Role Of Chemotherapymentioning

confidence: 99%

Review article: current treatment and optimal patient management in pancreatic cancer

Haycox

Lombard

Neoptolemos

et al. 1998

Aliment Pharmacol Ther

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A rationale for expanding the endpoints for clinical trials in advanced pancreatic carcinoma

Rothenberg¹,

Abbruzzese²,

Moore³

et al. 1996

Cancer

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BACKGROUND Using classical endpoints, such as response rate and survival, as the sole measures of benefit, little progress has been made in the treatment of advanced pancreatic carcinoma in the past 30 years. We challenge the assumption that response rate and survival are the only appropriate endpoints for clinical trials in this disease setting. METHOD. A review of the literature and roundtable discussion were undertaken. RESULTS. Using current imaging techniques, it is inherently difficult to distinguish pancreatic tumor from normal pancreas, inflammatory tissue, local fibrosis, and unopacified bowel. As a result, objective tumor measurements are often imprecise, unreliable, and irreproducible. This difficulty may explain the wide variation in response rates reported in clinical trials even when the same therapies are used. Tumor‐related symptoms, such as anorexia, weight loss, severe pain (requiring opioid analgesia), and impaired functional status, are prevalent and debilitating characteristics of this disease. Tools that can assess these symptoms in a consistent fashion over time have been developed and have been integrated into clinical trials to evaluate new drugs in this setting. CONCLUSIONS. Systematic assessment of the impact of a new therapy on tumor‐related symptoms may provide a sensitive and accurate way to identify useful new treatments for patients with advanced pancreatic carcinoma. Such analyses can be a useful complement to the classical endpoints of response rate and survival. Cancer 1996;78:627‐32.

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A rationale for expanding the endpoints for clinical trials in advanced pancreatic carcinoma

Rothenberg

Abbruzzese

Moore

et al. 1996

Cancer

View full text Add to dashboard Cite

BACKGROUND. Using classical endpoints, such as response rate and survival, as the sole measures of benefit, little progress has been made in the treatment of advanced pancreatic carcinoma in the past 30 years. We challenge the assumption that response rate and survival are the only appropriate endpoints for clinical trials in this disease setting. METHOD.A review of the literature and roundtable discussion were undertaken. RESULTS. Using current imaging techniques, it is inherently difficult to distinguish pancreatic tumor from normal pancreas, inflammatory tissue, local fibrosis, and unopacified bowel. As a result, objective tumor measurements are often imprecise, unreliable, and irreproducible. This difficulty may explain the wide variation in response rates reported in clinical trials even when the same therapies are used. Tumor-related symptoms, such as anorexia, weight loss, severe pain (requiring opioid analgesia), and impaired functional status, are prevalent and debilitating characteristics of this disease. Tools that can assess these symptoms in a consistent fashion over time have been developed and have been integrated into clinical trials to evaluate new drugs in this setting. CONCLUSIONS. Systematic assessment of the impact of a new therapy on tumorrelated symptoms may provide a sensitive and accurate way to identi@ useful new treatments for patients with advanced pancreatic carcinoma. Such analyses can be a useful complement to the classical endpoints of response rate and survival.

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A phase II trial of piroxantrone in adenocarcinoma of the pancreas

Cited by 10 publications

References 3 publications

Review article: current treatment and optimal patient management in pancreatic cancer

Review article: current treatment and optimal patient management in pancreatic cancer

A rationale for expanding the endpoints for clinical trials in advanced pancreatic carcinoma

A rationale for expanding the endpoints for clinical trials in advanced pancreatic carcinoma

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