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Paclitaxel as second-line chemotherapy in patients with gemcitabine-refractory pancreatic cancer: a retrospective study

  • Shimpei Maeda
  • Fuyuhiko Motoi
  • Tohru Onogawa
  • Takanori Morikawa
  • Ottomo Shigeru
  • Naoaki Sakata
  • Tatsuyuki Takadate
  • Takeshi Naitoh
  • Toshiki Rikiyama
  • Yu Katayose
  • Shinichi Egawa
  • Michiaki Unno
Original Article

Abstract

Background

We evaluated the efficacy and feasibility of paclitaxel in patients with gemcitabine-refractory pancreatic cancer. We also evaluated the correlation between tumor marker decline and response rate.

Methods

Thirty patients histologically diagnosed with pancreatic cancer who had undergone paclitaxel treatment as salvage chemotherapy were retrospectively analyzed. Paclitaxel treatment was performed with 80 mg/(m2 week) for 3 weeks followed by 1 week rest, and this was continued until failure. Tumor marker response was evaluated by measuring levels of carbohydrate antigen 19-9, carcinoembryonic antigen, and DUPAN-2 monthly.

Results

In total, 272 weekly paclitaxel treatments were performed. The median number of treatments per patient was 8 (range 1–22). The median overall survival from the start of paclitaxel treatment was 6.7 months (range 1.2–18.8). The response rate was 10% (3/30 patients) and the disease control rate was 46.7% (14/30 patients). Although grade 3 and 4 hematological and non-hematological toxicities were seen in 7 and 6 patients, respectively, adverse events were managed by conservative treatment. We found a significant correlation between the disease control rate and tumor marker decline within 2 months of paclitaxel treatment (P = 0.01). Patients with tumor marker decline tended to survive longer.

Conclusion

Weekly administration of paclitaxel in patients with gemcitabine-refractory pancreatic cancer seems to be well tolerated and can be effective. Paclitaxel treatment should be considered as salvage chemotherapy after gemcitabine failure in patients with good performance status.

Keywords

Paclitaxel Pancreatic cancer Second-line chemotherapy Gemcitabine 

Abbreviations

5-FU

5-Fluorouracil

CA

Carbohydrate antigen

CEA

Carcinoembryonic antigen

CR

Complete response

FF

5-Fluorouracil with folinic acid/leucovorin

GEM

Gemcitabine

OFF

5-Fluorouracil with folinic acid/leucovorin and oxaliplatin

PD

Progressive disease

PR

Partial response

PTX

Paclitaxel

RECIST

Response Evaluation Criteria in Solid Tumors

SD

Stable disease

TM

Tumor marker

UFT

Tegafur-uracil

Notes

Acknowledgment

This work supported in part by Grants-in-Aid for Scientific Research (C) 21591766 from Japan society for the Promotion of Science.

Conflict of interest

No author has any conflict of interest.

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Copyright information

© Japan Society of Clinical Oncology 2011

Authors and Affiliations

  • Shimpei Maeda
    • 1
  • Fuyuhiko Motoi
    • 1
  • Tohru Onogawa
    • 1
  • Takanori Morikawa
    • 1
  • Ottomo Shigeru
    • 1
  • Naoaki Sakata
    • 1
  • Tatsuyuki Takadate
    • 1
  • Takeshi Naitoh
    • 1
  • Toshiki Rikiyama
    • 1
  • Yu Katayose
    • 1
    • 2
  • Shinichi Egawa
    • 1
  • Michiaki Unno
    • 1
  1. 1.Division of Hepato-Biliary Pancreatic Surgery, Department of SurgeryTohoku University Graduate School of MedicineSendaiJapan
  2. 2.Division of Integrated Surgery and OncologyTohoku University Graduate School of MedicineSendaiJapan

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