Summary
Patients with advanced adenocarcinomas of the pancreas have an exceptionally poor prognosis. Modest activity has been demonstrated with single agents (response rates of 25% at best with 5-fluorouracil [5-FU] and mitomycin). Better results have not been obtained by combination chemotherapy.
Improvements in the palliation have been achieved by treatment with 5-FU, folinic acid (FA), and interferon-alpha-2A (IFN-α) weekly in the context of a phase II trial. Of 57 evaluable patients, eight (14%) had a partial response (PR), eight (14%) a minor response (MR), and 28 (49%) had no change of disease (NC). The median survival time was 10 mo for patients with progressive disease. Twenty-two out of 36 patients with tumor-related pain whose tumors were affected in terms of PR, MR, and NC became free of pain during treatment. Fever (56%), nausea (37%), and diarrhea (33%) were common toxicities observed. Therefore, biochemical modulation of 5-FU with FA and IFN-α shows some positive effects in the treatment of pancreatic cancer with moderate toxicity.
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References
Kelsen D. The use of chemotherapy in the treatment of advanced gastric and pancreas cancer.Semin Oncol 1994; 21: 58–66.
Moore M. Multicenter Study Group improvements in survival and clinical benefit with the use of gemcitabine (GEM) as first-line therapy for advanced pancreatic cancer: a randomized trial.Proc ASCO 1995; 547.
Bukowski RM, Balcerzak SP, O'Brian RM, Bonnett JD, Chen TT. Randomized trial of 5-fluorouracil and mitomycin C with or without streptozotocin for advanced pancreatic cancer. A South-West Oncology Group study.Cancer 1983; 52: 1577–1582.
Oster MW, Gray R, Panasci L, et al. Chemotherapy for advanced pancreatic cancer: a comparison of 5-fluorouracil, adriamycin, and mitomycin (FAM) with 5-fluorouracil, streptozotocin and mitomycin (FSM).Cancer 1986; 57: 29–33.
Gastrointestinal Tumor Study Group. Phase II studies of drug combination in avvanced pancreatic carcinoma: fluorouracil plus doxorubicin plus mitomycin-C and two regimens of streptozotocin plus mitomycin-C plus fluorouracil.J Clin Oncol 1986; 1794–1798.
Grem JL, Chu E, Boarman D, Balis FM, Murphy RF, McAtee N, Allegra CJ. Biochemical modulation of fluorouracil with leucovorin and interferon: preclinical and clinical investigations.Semin Oncol 1992; 19, 36–44.
Van der Wilt CL, Pinedo HM, Smid K, Cloos J, Noordhuis P, Peters GJ. Effect of folinic acid on fluorouracil activity and expression of thymidilate synthase.Semin Oncol 1992; 19: 16–24.
Bernhard H, Jäger-Arand E, Bernhard, G, Heike M, Klein O, Riemann JF, Meyer zum Büschenfelde K-H, Dippold W, Knuth A. Treatment of advanced pancreatic cancer with 5-fluorouracil, folinic acid and interferon alpha-2A: results of a phase 11 trial.Br J Cancer 1995; 71: 102–105.
Crown J, Casper ES, Botet J, Murray P, Kelsen DP. Lack of efficacy of high-dose leucovorin and fluorouracil in patients with advanced pancreatic adenocarcinoma.J Clin Oncol 1991; 9: 1682–1686.
Pazdur R, Ajani JJ, Abbruzzese JL, Belt RJ, Dakhil SR, Dubovsky D, Graham S, Pilat S, Winn R, Levin B. Phase II evaluation of fluorouracil and recombinant a-2a interferon in previously untreated patients with pancreatic adenocarcinoma.Cancer 1992; 70: 2073–2076.
Scheithauer W, Pfeffel F, Kornek G, Marczell A, Wiltschke C, Funovics J. A phase 11 trial of 5-fluorouracil, leucovorin and recombinant alpha-2b-interferon in advanced adenocarcinoma of the pancreas.Cancer 1992; 70: 1864–1866.
Johnston GP, Lenz H-J, Leichmann GC, Danenberg DK, Allegra JC, Dannenberg VP, Leichmann L. Thymidylate synthase gene and protein expression correlate and are associated with response to 5-fluorouracil in human colorectal and gastric tumors.Cancer Res 1995; 55: 1407–1412.
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Dippold, W., Bernhard, H. & Meyer zum Büschenfelde, KH. Chemotherapy in advanced pancreatic cancer. Int J Pancreatol 21, 39–41 (1997). https://doi.org/10.1007/BF02785918
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DOI: https://doi.org/10.1007/BF02785918