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.

Highlights

  • Aim: This study aimed to evaluate the efficacy of the low-dose gemcitabine over 6-hour infusion in patients with advanced pancreatic adenocarcinoma

  • There may be a benefit of that protocol in patients with bad performance status

  • The study was performed to assess the outcome of patients with locally advanced or metastatic pancreatic carcinoma when treated with prolonged infusion of low dose gemcitabine

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Summary

Introduction

In phase II study performed by Khaled et al.; 2008 in Egypt, 6 hours infusion of gemcitabine and cisplatin was an effective therapy for advanced cancer bladder; myelosuppression was mild. They concluded that the prolonged infusion of gemcitabine deserves to be tested in other malignancies [8]. The study was performed to assess the outcome of patients with locally advanced or metastatic pancreatic carcinoma when treated with prolonged infusion of low dose gemcitabine. Conclusion: Prolonged infusion of low dose gemcitabine is a tolerable and a good option in locally advanced or metastatic pancreatic carcinoma. More clinical trials with a combination of other cytotoxic agents or target therapy are needed to get better survival and lesser toxicity

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