roger

Br J Cancer. 2002 Aug 27;87(5):497-501.

Weekly gemcitabine plus Epirubicin as effective chemotherapy for advanced
pancreatic cancer: a multicenter phase II study.

Department of Internal Medicine, Oncological Day Hospital, University of
Florence, Italy

The current role of chemotherapy in pancreatic carcinoma is limited, and
progress in the treatment of this disease represents a significant challenge
to medical oncology. The most promising drug under study is gemcitabine, a
relatively new antimetabolite that represents an attractive candidate for
combination chemotherapy because of its excellent side-effect profile and
the absence of overlapping toxicities with other chemothe****utic agents.
Combined administration of gemcitabine and anthracyclines could result in
the induction of DNA breaks that are not easily repaired by the cell's
machinery, thus enhancing the apoptotic signals triggered by these lesions.
Forty-four patients with locally advanced and/or metastatic pancreatic
adenocarcinoma were enrolled in this multicenter study. Patients received
Epirubicin 20 mg m(-2) for 3 weeks followed by 1 week of rest (1 cycle) and
gemcitabine 1000 mg m(-2) after Epirubicin on the same day. All were
assessable for toxicity and response, 11 patients responded to treatment
with one complete response and 10 partial responses, for an overall response
rate of 25%. Median survival was 10.9 months (range, 2-26 months). Therapy
was well tolerated, with a low incidence of haematologic grade >2 toxicity.
A total of 12 of 27 (44.4%) eligible patients attained a clinical benefit
response. Our findings suggest that the gemcitabine-epirubicin schedule is
active and well tolerated in patients with advanced pancreatic cancer.

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