Combination Chemotherapy with Low-dose 5-FU, Cisplatin, and Gemcitabine for Gemcitabine-Refractory Pancreatic Cancer

Background : No single agent or combination therapy for advanced pancreatic cancer has been reported superior to single-agent GEM, and an effective second-line chemotherapy option is needed for patients who are resistant to first-line GEM therapy. Methods :We analyzed six patients who had disease progression following first-line gemcitabine therapy. Patients received second-line chemotherapy with low dose cisplatin, 5-fluorouracul or S-1,and gemcitabine every 21 days. Results : Two patients showed a partial response (33.3%) and two showed stable disease. Four patients (66.6%) showed a prolonged survival time with partial responses or stable disease.Median survival times were 7 and 11 months from the start of second-line therapy and the start of first-line gemcitabine therapy,respectively. In addition, all patients reported relief from pain and had a favorable performance status. The major toxicities of leucopenia, stomatitis, and diarrhea were found in one patient each.Conclusion : This second-line chemotherapy regimen is an effective option for patients with gemcitabineresistant pancreatic cancer.Article信州医学雑誌 57(6): 247-253(2009)journal articl