Cancer Chemotherapy and Pharmacology

, Volume 69, Issue 2, pp 425–430

The use of GTX as second-line and later chemotherapy for metastatic pancreatic cancer: a retrospective analysis


  • Hassan K. Dakik
    • Duke University Medical Center
  • Daniel J. Moskovic
    • Baylor College of Medicine
  • Peter J. Carlson
    • Baylor College of Medicine
  • Eric P. Tamm
    • The University of Texas MD Anderson Cancer Center
  • Wei Qiao
    • The University of Texas MD Anderson Cancer Center
  • Robert A. Wolff
    • The University of Texas MD Anderson Cancer Center
  • James L. Abbruzzese
    • The University of Texas MD Anderson Cancer Center
    • The University of Texas MD Anderson Cancer Center
Original Article

DOI: 10.1007/s00280-011-1705-x

Cite this article as:
Dakik, H.K., Moskovic, D.J., Carlson, P.J. et al. Cancer Chemother Pharmacol (2012) 69: 425. doi:10.1007/s00280-011-1705-x



There are limited data regarding the role of second-line treatment for metastatic pancreatic cancer (mPC) after the failure of initial chemotherapy. No data exist on the use of GTX after the failure of first-line therapy.

Patients and methods

We identified patients who were given GTX chemotherapy for a diagnosis of mPC after the failure of initial therapy. Demographic features, progression-free (PFS) and overall survival (OS), response to treatment, and toxicities were recorded.


The 59 evaluable patients received a median of 2 prior therapies. Three had no prior gemcitabine. Median PS was 1. Median survival was 22 weeks; progression-free survival was 9.9 weeks. Survival did not correlate with the number of prior regimens but trended with PS. There were no radiologic responses; those with stable disease (n = 21) had a better survival than those with progression (n = 29) or unevaluable patients (n = 9). Median survival was 38.3, 15.0, and 7.4 weeks, respectively. Grade 3 and 4 toxicities included leucopenia (n = 14), anemia (n = 7), and thrombocytopenia (n = 6). Hospitalizations were required in 21 patients, for febrile neutropenia (n = 7), non-neutropenic infection (n = 3), pulmonary embolus (n = 2), anemia or failure to thrive (n = 9). A 75% drop or more in CA 19-9 correlated with improved survival.


GTX is an active regimen in patients previously treated with gemcitabine for mPC. Better performance status and >75% drop in pretreatment CA 19-9 were associated with longer survival. The number of prior regimens did not predict for survival duration.


Pancreatic cancerChemotherapyAdenocarcinomaSurvival

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© Springer-Verlag 2011