Difference between revisions of "Pancreatic cancer - historical"

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The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. As a general rule, this includes the inferior arm(s) of a randomized study, unless said regimens continue to be recommended by trustworthy sources such as the [http://www.nccn.org/professionals/physician_gls/f_guidelines.asp NCCN Guidelines]. Is there a regimen missing from this list? See the [[Pancreatic_cancer|main pancreatic cancer page]] for current regimens.
+
The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. Is there a regimen missing from this list? See the [[Pancreatic_cancer|main pancreatic cancer page]] for current regimens.
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{| class="wikitable" style="float:right; margin-right: 5px;"
 
{| class="wikitable" style="float:right; margin-right: 5px;"
 
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<div style="background-color: #deebf6; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]]  |?Variant |limit=10000|format=sum}} [[Tutorial#Variants|variants]] on this page</b></font></div>
 
<div style="background-color: #deebf6; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]]  |?Variant |limit=10000|format=sum}} [[Tutorial#Variants|variants]] on this page</b></font></div>
 
|}  
 
|}  
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{{TOC limit|limit=3}}
 
{{TOC limit|limit=3}}
−
 
 
=Induction therapy for locally advanced disease, unresectable=
 
=Induction therapy for locally advanced disease, unresectable=
 
==FLEC {{#subobject:a6c123|Regimen=1}}==
 
==FLEC {{#subobject:a6c123|Regimen=1}}==
−
 
 
FLEC: '''<u>F</u>'''luorouracil, '''<u>L</u>'''eucovorin (Folinic acid), '''<u>E</u>'''pirubicin, '''<u>C</u>'''arboplatin
 
FLEC: '''<u>F</u>'''luorouracil, '''<u>L</u>'''eucovorin (Folinic acid), '''<u>E</u>'''pirubicin, '''<u>C</u>'''arboplatin
 +
<div class="toccolours" style="background-color:#ee6b6e">
 
===Regimen {{#subobject:ac72e0|Variant=1}}===
 
===Regimen {{#subobject:ac72e0|Variant=1}}===
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"  
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"  
 
! style="width: 20%" |Study
 
! style="width: 20%" |Study
−
! style="width: 20%" |Years of enrollment
+
! style="width: 20%" |Dates of enrollment
 
! style="width: 20%" |[[Levels_of_Evidence#Evidence|Evidence]]
 
! style="width: 20%" |[[Levels_of_Evidence#Evidence|Evidence]]
 
! style="width: 20%" |Comparator
 
! style="width: 20%" |Comparator
 
! style="width: 20%" |[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
! style="width: 20%" |[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
|-
 
|-
−
|[https://www.tandfonline.com/doi/abs/10.1179/joc.2004.16.6.589 Cantore et al. 2004]
+
|[https://doi.org/10.1179/joc.2004.16.6.589 Cantore et al. 2004]
 
|1997-2001
 
|1997-2001
 
| style="background-color:#1a9851" |Phase 3 (E-esc)
 
| style="background-color:#1a9851" |Phase 3 (E-esc)
 
|[[Pancreatic_cancer#Gemcitabine_monotherapy_2|Gemcitabine]]
 
|[[Pancreatic_cancer#Gemcitabine_monotherapy_2|Gemcitabine]]
−
| style="background-color:#91cf60" |Seems to have superior OS
+
| style="background-color:#91cf60" |Seems to have superior OS (primary endpoint)
 
|-
 
|-
 
|}
 
|}
 +
<div class="toccolours" style="background-color:#b3e2cd">
 
====Chemotherapy====
 
====Chemotherapy====
−
 
+
*[[Fluorouracil (5-FU)]] 1000 mg/m<sup>2</sup> IA bolus once on day 1
−
*[[Fluorouracil (5-FU)]]
+
*[[Leucovorin (Folinic acid)]] 100 mg/m<sup>2</sup> IA bolus once on day 1
−
*[[Folinic acid (Leucovorin)]]
+
*[[Epirubicin (Ellence)]] 60 mg/m<sup>2</sup> IA bolus once on day 1
−
*[[Epirubicin (Ellence)]]
+
*[[Carboplatin (Paraplatin)]] 300 mg/m<sup>2</sup> IA bolus once on day 1
−
*[[Carboplatin (Paraplatin)]]
+
'''21-day cycle for 3 cycles'''
−
 
+
</div></div>
 
===References===
 
===References===
−
 
+
#Cantore M, Fiorentini G, Luppi G, Rosati G, Caudana R, Piazza E, Comella G, Ceravolo C, Miserocchi L, Mambrini A, Del Freo A, Zamagni D, Rabbi C, Marangolo M. Gemcitabine versus FLEC regimen given intra-arterially to patients with unresectable pancreatic cancer: a prospective, randomized phase III trial of the Italian Society for Integrated Locoregional Therapy in Oncology. J Chemother. 2004 Dec;16(6):589-94. [https://doi.org/10.1179/joc.2004.16.6.589 link to original article] '''dosing details in abstract have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/15700852/ PubMed]
−
#Cantore M, Fiorentini G, Luppi G, Rosati G, Caudana R, Piazza E, Comella G, Ceravolo C, Miserocchi L, Mambrini A, Del Freo A, Zamagni D, Rabbi C, Marangolo M. Gemcitabine versus FLEC regimen given intra-arterially to patients with unresectable pancreatic cancer: a prospective, randomized phase III trial of the Italian Society for Integrated Locoregional Therapy in Oncology. J Chemother. 2004 Dec;16(6):589-94. [https://www.tandfonline.com/doi/abs/10.1179/joc.2004.16.6.589 link to original article] [https://pubmed.ncbi.nlm.nih.gov/15700852 PubMed]
 
  
 
=Metastatic disease, first-line=
 
=Metastatic disease, first-line=
 
==PEFG {{#subobject:f0e123|Regimen=1}}==
 
==PEFG {{#subobject:f0e123|Regimen=1}}==
−
 
 
PEFG: '''<u>P</u>'''latinol (Cisplatin), '''<u>E</u>'''pirubicin, '''<u>F</u>'''luorouracil, '''<u>G</u>'''emcitabine
 
PEFG: '''<u>P</u>'''latinol (Cisplatin), '''<u>E</u>'''pirubicin, '''<u>F</u>'''luorouracil, '''<u>G</u>'''emcitabine
 +
<div class="toccolours" style="background-color:#ee6b6e">
 
===Regimen {{#subobject:5d6ee0|Variant=1}}===
 
===Regimen {{#subobject:5d6ee0|Variant=1}}===
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"  
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"  
 
!style="width: 20%"|Study
 
!style="width: 20%"|Study
−
!style="width: 20%"|Years of enrollment
+
!style="width: 20%"|Dates of enrollment
 
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
!style="width: 20%"|Comparator
 
!style="width: 20%"|Comparator
 
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
|-
 
|-
−
|[https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(05)70175-3/abstract Reni et al. 2005]
+
|[https://doi.org/10.1016/S1470-2045(05)70175-3 Reni et al. 2005]
 
|2000-2003
 
|2000-2003
 
| style="background-color:#1a9851" |Phase 3 (E-esc)
 
| style="background-color:#1a9851" |Phase 3 (E-esc)
−
|[[Pancreatic_cancer#Gemcitabine_monotherapy_3|Gemcitabine]]
+
|[[Pancreatic_cancer#Gemcitabine_monotherapy_5|Gemcitabine]]
−
| style="background-color:#91cf60" |Seems to have superior PFS
+
| style="background-color:#1a9850" |Superior PFS4 (primary endpoint)<br>PFS4: 60% vs 28%<br>(HR 0.46, 95% CI 0.26-0.79)
 
|-
 
|-
 
|}
 
|}
 +
<div class="toccolours" style="background-color:#b3e2cd">
 
====Chemotherapy====
 
====Chemotherapy====
−
 
 
*[[Cisplatin (Platinol)]] 40 mg/m<sup>2</sup> IV once on day 1
 
*[[Cisplatin (Platinol)]] 40 mg/m<sup>2</sup> IV once on day 1
 
*[[Epirubicin (Ellence)]] 40 mg/m<sup>2</sup> IV once on day 1
 
*[[Epirubicin (Ellence)]] 40 mg/m<sup>2</sup> IV once on day 1
 
*[[Fluorouracil (5-FU)]] 200 mg/m<sup>2</sup>/day IV continuous infusion over 28 days, started on day 1 (total dose per cycle: 5600 mg/m<sup>2</sup>)
 
*[[Fluorouracil (5-FU)]] 200 mg/m<sup>2</sup>/day IV continuous infusion over 28 days, started on day 1 (total dose per cycle: 5600 mg/m<sup>2</sup>)
 
*[[Gemcitabine (Gemzar)]] 600 mg/m<sup>2</sup> IV over 60 minutes once per day on days 1 & 8
 
*[[Gemcitabine (Gemzar)]] 600 mg/m<sup>2</sup> IV over 60 minutes once per day on days 1 & 8
−
 
 
'''28-day cycles'''
 
'''28-day cycles'''
−
 
+
</div></div>
 
===References===
 
===References===
−
 
+
#Reni M, Cordio S, Milandri C, Passoni P, Bonetto E, Oliani C, Luppi G, Nicoletti R, Galli L, Bordonaro R, Passardi A, Zerbi A, Balzano G, Aldrighetti L, Staudacher C, Villa E, Di Carlo V. Gemcitabine versus cisplatin, epirubicin, fluorouracil, and gemcitabine in advanced pancreatic cancer: a randomised controlled multicentre phase III trial. Lancet Oncol. 2005 Jun;6(6):369-76. [https://doi.org/10.1016/S1470-2045(05)70175-3 link to original article] '''dosing details in abstract have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/15925814/ PubMed]
−
#Reni M, Cordio S, Milandri C, Passoni P, Bonetto E, Oliani C, Luppi G, Nicoletti R, Galli L, Bordonaro R, Passardi A, Zerbi A, Balzano G, Aldrighetti L, Staudacher C, Villa E, Di Carlo V. Gemcitabine versus cisplatin, epirubicin, fluorouracil, and gemcitabine in advanced pancreatic cancer: a randomised controlled multicentre phase III trial. Lancet Oncol. 2005 Jun;6(6):369-76. [https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(05)70175-3/abstract link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/15925814 PubMed]
 
  
 
=Metastatic disease, all lines of therapy=
 
=Metastatic disease, all lines of therapy=
 
==SMF {{#subobject:f7dcb5|Regimen=1}}==
 
==SMF {{#subobject:f7dcb5|Regimen=1}}==
−
 
 
SMF: '''<u>S</u>'''treptozotocin, '''<u>M</u>'''itomycin, 5-'''<u>F</u>'''luorouracil
 
SMF: '''<u>S</u>'''treptozotocin, '''<u>M</u>'''itomycin, 5-'''<u>F</u>'''luorouracil
 +
<div class="toccolours" style="background-color:#ee6b6e">
 
===Regimen {{#subobject:251b74|Variant=1}}===
 
===Regimen {{#subobject:251b74|Variant=1}}===
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"  
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"  
 
!style="width: 20%"|Study
 
!style="width: 20%"|Study
−
!style="width: 20%"|Years of enrollment
+
!style="width: 20%"|Dates of enrollment
 
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
!style="width: 20%"|Comparator
 
!style="width: 20%"|Comparator
 
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
|-
 
|-
−
|[https://doi.org/10.1002/1097-0142(19910901)68:5<965::aid-cncr2820680509>3.0.co;2-2 Kelsen et al. 1991]
+
|[https://doi.org/10.1002/1097-0142(19910901)68:5%3C965::aid-cncr2820680509%3E3.0.co;2-2 Kelsen et al. 1991]
 
|1987-1989
 
|1987-1989
 
| style="background-color:#1a9851" |Phase 3 (C)
 
| style="background-color:#1a9851" |Phase 3 (C)
−
|[[#CAC_99|CAC]]
+
|[[#CAC_999|CAC]]
 
| style="background-color:#1a9850" |Superior OS
 
| style="background-color:#1a9850" |Superior OS
 
|-
 
|-
 
|}
 
|}
 +
<div class="toccolours" style="background-color:#b3e2cd">
 
====Chemotherapy====
 
====Chemotherapy====
−
*[[Streptozocin (Zanosar)]]
+
*[[Streptozocin (Zanosar)]] 1000 mg/m<sup>2</sup> IV once per day on days 1, 8, 29, 36
−
*[[Mitomycin (Mutamycin)]]
+
*[[Mitomycin (Mutamycin)]] 10 mg/m<sup>2</sup> IV once on day 1
−
*[[Fluorouracil (5-FU)]]
+
*[[Fluorouracil (5-FU)]] 600 mg/m<sup>2</sup> IV once per day on days 1, 8, 29, 36
−
 
+
'''8-week cycles'''
 +
</div></div>
 
===References===
 
===References===
−
#Kelsen D, Hudis C, Niedzwiecki D, Dougherty J, Casper E, Botet J, Vinciguerra V, Rosenbluth R. A phase III comparison trial of streptozotocin, mitomycin, and 5-fluorouracil with cisplatin, cytosine arabinoside, and caffeine in patients with advanced pancreatic carcinoma. Cancer. 1991 Sep 1;68(5):965-9. [https://doi.org/10.1002/1097-0142(19910901)68:5<965::aid-cncr2820680509>3.0.co;2-2 link to original article] [https://pubmed.ncbi.nlm.nih.gov/1833042/ PubMed]
+
#Kelsen D, Hudis C, Niedzwiecki D, Dougherty J, Casper E, Botet J, Vinciguerra V, Rosenbluth R. A phase III comparison trial of streptozotocin, mitomycin, and 5-fluorouracil with cisplatin, cytosine arabinoside, and caffeine in patients with advanced pancreatic carcinoma. Cancer. 1991 Sep 1;68(5):965-9. [https://doi.org/10.1002/1097-0142(19910901)68:5%3C965::aid-cncr2820680509%3E3.0.co;2-2 link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/1833042/ PubMed]
−
 
 
 
[[Category:Pancreatic cancer regimens]]
 
[[Category:Pancreatic cancer regimens]]
 
[[Category:Disease-specific pages]]
 
[[Category:Disease-specific pages]]
 
[[Category:Gastrointestinal cancers]]
 
[[Category:Gastrointestinal cancers]]
 
[[Category:Historical regimens]]
 
[[Category:Historical regimens]]

Latest revision as of 23:34, 15 July 2024

The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. Is there a regimen missing from this list? See the main pancreatic cancer page for current regimens.

3 regimens on this page
3 variants on this page


Induction therapy for locally advanced disease, unresectable

FLEC

FLEC: Fluorouracil, Leucovorin (Folinic acid), Epirubicin, Carboplatin

Regimen

Study Dates of enrollment Evidence Comparator Comparative Efficacy
Cantore et al. 2004 1997-2001 Phase 3 (E-esc) Gemcitabine Seems to have superior OS (primary endpoint)

Chemotherapy

21-day cycle for 3 cycles

References

  1. Cantore M, Fiorentini G, Luppi G, Rosati G, Caudana R, Piazza E, Comella G, Ceravolo C, Miserocchi L, Mambrini A, Del Freo A, Zamagni D, Rabbi C, Marangolo M. Gemcitabine versus FLEC regimen given intra-arterially to patients with unresectable pancreatic cancer: a prospective, randomized phase III trial of the Italian Society for Integrated Locoregional Therapy in Oncology. J Chemother. 2004 Dec;16(6):589-94. link to original article dosing details in abstract have been reviewed by our editors PubMed

Metastatic disease, first-line

PEFG

PEFG: Platinol (Cisplatin), Epirubicin, Fluorouracil, Gemcitabine

Regimen

Study Dates of enrollment Evidence Comparator Comparative Efficacy
Reni et al. 2005 2000-2003 Phase 3 (E-esc) Gemcitabine Superior PFS4 (primary endpoint)
PFS4: 60% vs 28%
(HR 0.46, 95% CI 0.26-0.79)

Chemotherapy

28-day cycles

References

  1. Reni M, Cordio S, Milandri C, Passoni P, Bonetto E, Oliani C, Luppi G, Nicoletti R, Galli L, Bordonaro R, Passardi A, Zerbi A, Balzano G, Aldrighetti L, Staudacher C, Villa E, Di Carlo V. Gemcitabine versus cisplatin, epirubicin, fluorouracil, and gemcitabine in advanced pancreatic cancer: a randomised controlled multicentre phase III trial. Lancet Oncol. 2005 Jun;6(6):369-76. link to original article dosing details in abstract have been reviewed by our editors PubMed

Metastatic disease, all lines of therapy

SMF

SMF: Streptozotocin, Mitomycin, 5-Fluorouracil

Regimen

Study Dates of enrollment Evidence Comparator Comparative Efficacy
Kelsen et al. 1991 1987-1989 Phase 3 (C) CAC Superior OS

Chemotherapy

8-week cycles

References

  1. Kelsen D, Hudis C, Niedzwiecki D, Dougherty J, Casper E, Botet J, Vinciguerra V, Rosenbluth R. A phase III comparison trial of streptozotocin, mitomycin, and 5-fluorouracil with cisplatin, cytosine arabinoside, and caffeine in patients with advanced pancreatic carcinoma. Cancer. 1991 Sep 1;68(5):965-9. link to original article dosing details in manuscript have been reviewed by our editors PubMed
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