Gemcitabine concurrent with continuous infusional 5-fluorouracil in advanced biliary cancers: a review of the Princess Margaret Hospital experience.

Abstract

BACKGROUND:

Unresectable biliary tract cancer has a very poor prognosis. A combination of weekly gemcitabine plus continuous infusional 5-fluorouracil (5-FU) (GEM/CVI 5-FU) was evaluated as therapy for this cancer.

PATIENTS AND METHODS:

The charts of 27 patients with advanced biliary tract adenocarcinoma treated with GEM/CVI 5-FU at the Princess Margaret Hospital were evaluated for response, survival and toxicity. The treatment consisted of a 30-min infusion of gemcitabine at 900 mg/m(2) on days 1, 8 and 15 of a 28-day cycle plus 5-FU given via a peripherally inserted central line at 200 mg/m(2)/day continuously for 21 days, every 28 days.

RESULTS:

Objective responses were observed in nine patients (33%; 95% confidence interval 17% to 54%). An additional eight patients (30%) achieved stable disease for a median of 4 months (range 2.3-11). Median time to progression and overall survival were 3.7 and 5.3 months, respectively. Direct chemotherapy-related toxicity was mild, with only 11% grade > or =3 myelosuppression. Central venous catheter complications were common (26%). There were no treatment-related deaths.

CONCLUSIONS:

This study shows that GEM/CVI 5-FU is active and well tolerated in advanced and metastatic biliary tract cancers.

• Authors: J J Knox, D Hedley, A Oza, L L Siu, G R Pond, M J Moore
• Journal: Annals of oncology : official journal of the European Society for Medical Oncology (Ann Oncol) Vol. 15 Issue 5 Pg. 770-4 (May 2004) ISSN: 0923-7534 [Print] England
• PMID: 15111345 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Deoxycytidine
• Fluorouracil
• Gemcitabine

Topics

• Adenocarcinoma (drug therapy)
• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Bile Duct Neoplasms (drug therapy, pathology)
• Bile Ducts, Intrahepatic (pathology)
• Cholangiocarcinoma (drug therapy, pathology)
• Deoxycytidine (administration & dosage, analogs & derivatives)
• Disease Progression
• Drug Administration Schedule
• Female
• Fluorouracil (administration & dosage)
• Gallbladder Neoplasms (drug therapy, pathology)
• Humans
• Infusions, Intravenous
• Male
• Middle Aged
• Prognosis
• Retrospective Studies
• Survival Analysis
• Treatment Outcome
• Gemcitabine