Salvage Chemotherapy with Mitomycin, Docetaxel, and Irinotecan (MDI Regimen) in Metastatic Pancreatic Adenocarcinoma: A Phase I and II Trial

Abstract

The MTD was mitomycin 6 mg/m2 day one, and docetaxel 30 and irinotecan 85 mg/m2 days 2 and 8. This regimen is inactive in metastatic pancreatic cancer.

Raltitrexed–eloxatin salvage chemotherapy in gemcitabine-resistant metastatic pancreatic cancer

“…As no further standard therapeutic option exists and scarce information on the impact on outcome of salvage therapy is available, prospective trials attempting to widen the therapeutic armamentarium against this disease are warranted. So far, very few studies have investigated salvage chemotherapy after failure of gemcitabine or gemcitabine-containing chemotherapy (Stehlin et al, 1999;Oettle et al, 2000;Ulrich-Pur et al, 2003;Cantore et al, 2004;Milella et al, 2004; Reni et al, 2004), one of which was retrospective (Kozuch et al, 2001). The populations selected were different in terms of proportion of patients with PS480, which ranged from 0 to 61%, metastatic patients (73 -100%), patients with liver metastases (57 -85%), patients with 41 prior chemotherapy lines (0 -29%), and median PFS after previous treatment (6.0 -7.9 months), which was rarely reported in other series, while in our exploratory analyses it resulted as an independent factor predicting the outcome of salvage therapy (Table 6).…”

“…The populations selected were different in terms of proportion of patients with PS480, which ranged from 0 to 61%, metastatic patients (73 -100%), patients with liver metastases (57 -85%), patients with 41 prior chemotherapy lines (0 -29%), and median PFS after previous treatment (6.0 -7.9 months), which was rarely reported in other series, while in our exploratory analyses it resulted as an independent factor predicting the outcome of salvage therapy (Table 6). Furthermore, the sample size of most series is limited to o20 patients per treatment arm (Oettle et al, 2000;Ulrich-Pur et al, 2003;Milella et al, 2004;Reni et al, 2004), thus producing data with very large CIs. Given these differences, (Kozuch et al, 2001;Ulrich-Pur et al, 2003;Milella et al, 2004) and compares favourably with the 0 -10% objective responses reported elsewhere (Stehlin et al, 1999;Oettle et al, 2000;Ulrich-Pur et al, 2003;Cantore et al, 2004;Reni et al, 2004).…”

Current Perspectives and Future Trends of Systemic Therapy in Advanced Pancreatic Carcinoma

“…In light of these results, both regimens may be reasonable options for secondline therapy in appropriately selected patients with advanced pancreatic cancer. Other irinotecan-based regimens including combinations with raltitrexed (Ulrich-Pur, 2003, as cited in Gounaris, 2010), docetaxel (Ko et al, 2008), docetaxel and mitomycin C (Reni et al, 2004) or ifosfamide (Cereda et al, 2011) have not achieved positive results in small phase II trials.…”

Triplet cytotoxic chemotherapy with gemcitabine, 5-fluorouracil and cisplatin for advanced pancreatic cancer

“…However, gemcitabine monotherapy remains the reference regimen for advanced pancreatic cancer (2,27), as the combination of gemcitabine with other cytotoxic drugs has not shown significant benefit, except in three studies (28)(29)(30). In phase II trials of triplet cytotoxic chemotherapy [i.e., gemcitabine/docetaxel/capecitabine, gemcitabine/oxaliplatin/5-FU, gemcitabine/5-FU/cisplatin (GFP) or mitomycin/docetaxel/irinotecan], the previously reported overall response rate was between 0 and 33.3% and the median OS time was between 6.1 and 14.5 months (31)(32)(33)(34)(35). Although the response rate in the present study was acceptable, the 5.9-month median OS time may appear to be inferior to those of the reported phase II triplet trials.…”