Newer approaches to gemcitabine-based therapy of pancreatic cancer: Fixed-dose-rate infusion and novel agents

Howard S. Hochster

Research output: Contribution to journalReview articlepeer-review

23 Scopus citations

Abstract

Purpose: To review the use of gemcitabine-based therapy in pancreatic cancer, including fixed-dose-rate (FDR) infusion and novel combinations. Results: On the basis of pharmacokinetic data, studies have been performed using an FDR of gemcitabine of 10 mg/m2/min in an effort to maintain a critical plasma concentration of gemcitabine, and thus increase tumor cytotoxicity and therapeutic efficacy. The dose-limiting toxicities in Phase I studies were mucositis and myelosuppression. A multicenter Phase II study compared two schedules of gemcitabine in patients with pancreatic cancer, a single dose of 2200 mg/m2 infused for 30 min, and a constant infusion of 1500 mg/m2 given at 10 mg/m2/min. A somewhat improved response rate and survival for the FDR arm compared with the 30-min-infusion arm was observed. In addition, a wide variety of new compounds targeting specific molecules involved in cell control, cell growth, and apoptosis have been used in combination with gemcitabine and are reviewed. Conclusion: Further development of FDR gemcitabine in combination with other chemotherapeutic agents is ongoing. Because none of the new compounds investigated has as yet shown improvement compared with single-agent gemcitabine in prospectively randomized trials, gemcitabine remains the standard of care in pancreatic cancer.

Original languageEnglish (US)
Pages (from-to)24-30
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume56
Issue number4 SUPPL.
DOIs
StatePublished - Jul 15 2003
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Keywords

  • Fixed-dose-rate
  • Gemcitabine
  • Novel agents
  • Pancreatic cancer

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