Clinical Study

British Journal of Cancer (2006) 94, 785–791. doi:10.1038/sj.bjc.6603026 www.bjcancer.com
Published online 28 February 2006

Raltitrexed–eloxatin salvage chemotherapy in gemcitabine-resistant metastatic pancreatic cancer

A summary of the data presented in this manuscript was selected for poster presentation at the 2005 Annual meeting of the American Society for Clinical Oncology and was published as part of the proceedings.

M Reni1, L Pasetto2, G Aprile3, S Cordio4, E Bonetto5, S Dell'oro1, P Passoni1, L Piemonti6, C Fugazza1, G Luppi7, C Milandri8, R Nicoletti5, A Zerbi9, G Balzano9, V Di Carlo9 and A A Brandes2

  1. 1Department of Oncology, S. Raffaele Hsc. Scientific Inst., via Olgettina 60, 20132 Milan, Italy
  2. 2Department of Oncology, Azienda Ospedaliera and University, Padova, Italy
  3. 3Department of Oncology, Policlinico Universitario, Udine, Italy
  4. 4Department of Oncology, Garibaldi-Nesima H. Catania, Catania, Italy
  5. 5Department of Radiology, S. Raffaele Hsc. Scientific Inst., Milan, Italy
  6. 6Laboratory of Experimental Surgery, Department of Diabetes and Transplant Immunology, S. Raffaele Hsc. Scientific Inst., Milan, Italy
  7. 7Department of Medical Oncology, Azienda Ospedaliera-Policlinico, Modena, Italy
  8. 8Department of Oncology, Pierantoni H. Forlì, Forlì, Italy
  9. 9Department of Surgery, S. Raffaele Hsc. Scientific Inst., Milan, Italy

Correspondence: Dr M Reni, E-mail: reni.michele@hsr.it

Received 22 September 2005; Revised 1 February 2006; Accepted 1 February 2006; Published online 28 February 2006.

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Abstract

Limited information on salvage treatment in patients affected by pancreatic cancer is available. At failure, about half of the patients present good performance status (PS) and are candidate for further treatment. Patients >18 years, PS greater than or equal to50, with metastatic pancreatic adenocarcinoma previously treated with gemcitabine-containing chemotherapy, and progression-free survival (PFS) <12 months received a combination of raltitrexed (3 mg m-2) and oxaliplatin (130 mg m-2) every 3 weeks until progression, toxicity, or a maximum of six cycles. A total of 41 patients received 137 cycles of chemotherapy. Dose intensity for both drugs was 92% of the intended dose. Main grade >2 toxicity was: neutropenia in five patients (12%), thrombocytopenia, liver and vomiting in three (7%), fatigue in two (5%). In total, 10 patients (24%) yielded a partial response, 11 a stable disease. Progression-free survival at 6 months was 14.6%. Median survival was 5.2 months. Survival was significantly longer in patients with previous PFS >6 months and in patients without pancreatic localisation. A clinically relevant improvement of quality of life was observed in numerous domains. Raltitrexed–oxaliplatin regimen may constitute a treatment opportunity in gemcitabine-resistant metastatic pancreatic cancer. Previous PFS interval may allow the identification of patients who are more likely to benefit from salvage treatment.

Keywords:

chemotherapy, metastatic disease, oxaliplatin, pancreatic cancer, raltitrexed, salvage therapy