Stained glass windows by Tommaso Juglaris at Goddard  Chapel at Tufts University. Medford, MA, USA (Emily Zilm for Tufts University)

Highlights on the First Line Treatment of Metastatic Pancreatic Cancer

Krishna S Gunturu, Jamie Jarboe, Muhammad Wasif Saif

Abstract


Pancreatic cancer is the fourth leading cause of cancer deaths in men and women. The estimated deaths from pancreatic cancer in 2012 in the United States are 37,390, and the five-year survival for all patients with pancreatic adenocarcinoma is less than 5%. Majority of patients present with incurable metastatic pancreatic cancer. The 2012 American Society of Oncology (ASCO) Annual Meeting offered new insights into metastatic pancreatic cancer and we discuss Abstracts #4018, #4019, #4022, #4042, #4043, #4048, #4050 and comment on them in this paper.

Image: Stained glass windows by Tommaso Juglaris at Goddard  Chapel at Tufts University. Medford, MA, USA (Emily Zilm for Tufts University).


Keywords


Drug Therapy; gemcitabine; Neoplasm Metastasis; Pancreatic Neoplasms

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References


Jemal A, Siegel R, Xu J, et al. Cancer statistics, 2010. CA Cancer J Clin 2010;60:277-300.

Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012. CA Cancer J Clin 2012;62:10-29.

Burris HA, 3rd, Moore MJ, Andersen J, et al. Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial. J Clin Oncol 1997;15:2403-2413.

Rocha Lima CM, Green MR, Rotche R, et al. Irinotecan plus gemcitabine results in no survival advantage compared with gemcitabine monotherapy in patients with locally advanced or metastatic pancreatic cancer despite increased tumor response rate. J Clin Oncol 2004;22:3776-3783.

Heinemann V, Boeck S, Hinke A, et al. Meta-analysis of randomized trials: evaluation of benefit from gemcitabine-based combination chemotherapy applied in advanced pancreatic cancer. BMC Cancer 2008;8:82.

Heinemann V, Quietzsch D, Gieseler F, et al. Randomized phase III trial of gemcitabine plus cisplatin compared with gemcitabine alone in advanced pancreatic cancer. J Clin Oncol 2006;24:3946-3952.

Herrmann R, Bodoky G, Ruhstaller T, et al. Gemcitabine plus capecitabine compared with gemcitabine alone in advanced pancreatic cancer: a randomized, multicenter, phase III trial of the Swiss Group for Clinical Cancer Research and the Central European Cooperative Oncology Group. J Clin Oncol 2007;25:2212-2217.

Conroy T, Desseigne F, Ychou M, et al. FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med 2011;364:1817-1825.

Trouilloud I, Dupont-Gossard AC, Artru P, Lecomte T, Gauthier M, Thomas Aparicio T, et al. FOLFIRI.3 (CPT-11 plus folinic acid plus 5-FU) alternating with gemcitabine or gemcitabine (G) alone in patients (pts) with previously untreated metastatic pancreatic adenocarcinoma (MPA): Results of the randomized multicenter AGEO phase II trial FIRGEM. J Clin Oncol 2012; 30(Suppl):Abstract 4018.

Philip PA, Goldman BH, Ramanathan RK, Lenz HJ, Lowy AM, Whitehead RP, et al. Dual blockade of epidermal growth factor receptor (EGFR) and insulin-like growth factor receptor-1 (IGF-1R) signaling in metastatic pancreatic cancer: Phase I/randomized phase II trial of gemcitabine, erlotinib, and cixutumumab versus gemcitabine plus erlotinib (SWOG-0727). J Clin Oncol 2012; 30(Suppl):Abstract 4019.

Fjallskog ML, Lejonklou MH, Oberg KE, et al. Expression of molecular targets for tyrosine kinase receptor antagonists in malignant endocrine pancreatic tumors. Clin Cancer Res 2003;9:1469-1473.

Moore MJ, Goldstein D, Hamm J, et al. Erlotinib plus gemcitabine compared with gemcitabine alone in patients with advanced pancreatic cancer: a phase III trial of the National Cancer Institute of Canada Clinical Trials Group. J Clin Oncol 2007;25:1960-1966.

Kullmann F, Hartmann A, Stohr R, et al. KRAS mutation in metastatic pancreatic ductal adenocarcinoma: results of a multicenter phase II study evaluating efficacy of cetuximab plus gemcitabine/oxaliplatin (GEMOXCET) in first-line therapy. Oncology 2011;81:3-8.

Catenacci DVT, Bahary N, Edelman MJ, Nattam SR, de Wilton Marsh R, Kaubisch A, et al. A phase IB/randomized phase II study of gemcitabine (G) plus placebo (P) or vismodegib (V), a hedgehog (Hh) pathway inhibitor, in patients (pts) with metastatic pancreatic cancer (PC): Interim analysis of a University of Chicago phase II consortium study. J Clin Oncol 2012; 30(Suppl):Abstract 4022.

Ogden SK, Ascano M, Jr., Stegman MA, et al. Regulation of Hedgehog signaling: a complex story. Biochem Pharmacol 2004;67:805-814.

Fuchs CS, Ikeda M, Bodoky G, Okusaka T, Ohkawa S, Mizuno N, et al. A phase III trial of ganitumab (GAN, AMG 479) with gemcitabine (G) as first-line treatment (tx) in patients (pts) with metastatic pancreatic cancer (MPC): An analysis of safety from the GAMMA trial (GEM and AMG 479 in Metastatic Adenocarcinoma of the Pancreas). J Clin Oncol 2012; 30(Suppl):Abstract 4042.

Poplin E, Feng Y, Berlin J, et al. Phase III, randomized study of gemcitabine and oxaliplatin versus gemcitabine (fixed-dose rate infusion) compared with gemcitabine (30-minute infusion) in patients with pancreatic carcinoma E6201: a trial of the Eastern Cooperative Oncology Group. J Clin Oncol 2009;27:3778-3785.

Ocean AJ, Guarino MJ, Pennington KL, Springett GM, Gulec SA, Bekaii-Saab TS, et al. Phase I/II study of 90Y-clivatuzumab tetraxetan (90Y-hPAM4) combined with gemcitabine (Gem) in advanced pancreatic cancer (APC): Final results. J Clin Oncol 2012; 30(Suppl):Abstract 4043.

Morschhauser F, Kraeber-Bodere F, Wegener WA, et al. High rates of durable responses with anti-CD22 fractionated radioimmunotherapy: results of a multicenter, phase I/II study in non-Hodgkin's lymphoma. J Clin Oncol 2010;28:3709-3716.

Cardillo TM, Blumenthal R, Ying Z, et al. Combined gemcitabine and radioimmunotherapy for the treatment of pancreatic cancer. Int J Cancer 2002;97:386-392.

Gold DV, Schutsky K, Modrak D, et al. Low-dose radioimmunotherapy ((90)Y-PAM4) combined with gemcitabine for the treatment of experimental pancreatic cancer. Clin Cancer Res 2003;9:3929S-3937S.

Truong TG, Tempero MA, Kantoff E, Jones K, Dito E, Ong A, Ko AH. A phase I study of nab-paclitaxel (A), gemcitabine (GEM), and capecitabine (X) in patients with metastatic pancreatic adenocarcinoma (MPA). J Clin Oncol 2012; 30(Suppl):Abstract 4048.

Cunningham D, Chau I, Stocken DD, et al. Phase III randomized comparison of gemcitabine versus gemcitabine plus capecitabine in patients with advanced pancreatic cancer. Clin Oncol 2009;27:5513-5518.

Hu J, Zhao G, Wang HX, et al. A meta-analysis of gemcitabine containing chemotherapy for locally advanced and metastatic pancreatic adenocarcinoma. J Hematol Oncol 2011;4:11.

Van Laethem JL, Heinemann V, Martens UM, Jassem J, Michl P, Peeters M, Weekes CD, Marechal R, Stieler J, Giurescu M, Rajagopalan P, Garosi VL, et al. A phase I/II study of the MEK inhibitor BAY 86-9766 (BAY) in combination with gemcitabine (GEM) in patients with nonresectable, locally advanced or metastatic pancreatic cancer (PC): Phase I dose-escalation results. J Clin Oncol 2012; 30(Suppl):Abstract 4050.

Almoguera C, Shibata D, Forrester K, et al. Most human carcinomas of the exocrine pancreas contain mutant c-K-ras genes. Cell 1988;53:549-554.

Krishna Soujanya Gunturu JRT, Howard S. Hochster, Stacey Stein, Xiaopan Yao, Xiangyu Cong, Jill Lacy et.al. Single-institution experience with FOLFIRINOX in advanced pancreatic cancer (PC). J Clin Oncol 2012;suppl 4; abstr 330.




DOI: http://dx.doi.org/10.6092/1590-8577/963

NBN: http://nbn.depositolegale.it/urn%3Anbn%3Ait%3Aunina-14137

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