Prolonged Infusion of Low Dose Gemcitabine in Advanced Pancreatic Carcinoma

Abstract

Background: Gemcitabine was established as a monotherapy or in combination for locally advanced or metastatic pancreatic carcinoma. Aim: This study aimed to evaluate the efficacy of the low-dose gemcitabine over 6-hour infusion in patients with advanced pancreatic adenocarcinoma. Methods: 26 patients with locally advanced or metastatic pancreatic carcinoma were recruited into the study from December 2013 to October 2014. Patients received the treatment in Clinical Oncology Department, Sohag University, and Medical Oncology Department, Assiut University. Patients received low-dose gemcitabine (250 mg/m2) over 6-hour infusion, weekly for seven weeks and then on days 1 and 8 every 3 weeks till unacceptable toxicity or progression of the disease. Results: Twenty-six patients were enrolled in this study. After starting 7 weeks of treatment, the disease control rate was 38.5% in the form of complete response in 3.8% of patients, partial response in 26.9%, and stationary response in 7.7%. However, disease progression occurred in 61.5%. Progression-free survivals were 65.38%, 23.07%, 7.69% and 3.84% after 3, 6, 9 and 12 months, respectively. Also, overall survivals at 3-month, 6-month, 9-month, and 12-month were 61.53%, 42.30%, 23.07%, and 7.69%, respectively. Conclusion: Prolonged infusion of low dose gemcitabine is a tolerable and a good option in locally advanced or metastatic pancreatic carcinoma. There may be a benefit of that protocol in patients with bad performance status. More clinical trials with a combination of other cytotoxic agents or target therapy are needed to get better survival and lesser toxicity.