Skip to main content
Erschienen in: Cancer Chemotherapy and Pharmacology 6/2009

01.05.2009 | Original Article

Irinotecan monotherapy as second-line treatment in advanced pancreatic cancer

verfasst von: Seong Yoon Yi, Young Suk Park, Hyo Song Kim, Hyun Jung Jun, Kyoung Ha Kim, Myung Hee Chang, Min Jae Park, Ji Eun Uhm, Jeeyun Lee, Se Hoon Park, Joon Oh Park, Jong Kyun Lee, Kyu Taek Lee, Ho Yeong Lim, Won Ki Kang

Erschienen in: Cancer Chemotherapy and Pharmacology | Ausgabe 6/2009

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The phase II study was conducted to evaluate the efficacy and safety of irinotecan as salvage single-agent chemotherapy in patients with advanced pancreatic cancer.

Methods

Patients with measurable metastatic pancreatic cancer, progressive after previous gemcitabine-based chemotherapy were treated with irinotecan 150 mg/m2 every 2 weeks. Treatment was repeated until disease progression or unacceptable toxicity.

Results

Between March 2004 to February 2007, 33 patients were registered and treated with irinotecan monotherapy. The patients’ median age was 59 years (range 36–70) and two had an ECOG performance status of 2. A total of 167 chemotherapy cycles were delivered (median, 4; range 2–12). In an intent-to-treat analysis, three (9%) confirmed partial response and 13 patients with stable disease were observed for a disease control rate of 48%. The median progression-free and overall survivals were 2.0 months (95% CI, 0.7–3.3) and 6.6 months (95% CI, 5.8–7.4), respectively. Toxic effects were mainly gastrointestinal (nausea in 64% of patients, diarrhea in 36%), Toxicity profiles were generally predictable and manageable, and there was no treatment-related death.

Conclusions

Second-line chemotherapy with single-agent irinotecan is marginally effective and well tolerated regimen for gemcitabine-pretreated patients with advanced pancreatic cancer.
Literatur
1.
Zurück zum Zitat Bae JM, Won YJ, Jung KW, Park JG (2002) Annual report of the Korean central cancer registry program 2000. Cancer Res Treat 34:77–83 Bae JM, Won YJ, Jung KW, Park JG (2002) Annual report of the Korean central cancer registry program 2000. Cancer Res Treat 34:77–83
2.
Zurück zum Zitat Bissery MC, Vrignaud P, Lavelle F, Chabot GG (1996) Experimental antitumor activity and pharmacokinetics of the camptothecin analog irinotecan (CPT-11) in mice. Anticancer Drugs 7:437–460PubMedCrossRef Bissery MC, Vrignaud P, Lavelle F, Chabot GG (1996) Experimental antitumor activity and pharmacokinetics of the camptothecin analog irinotecan (CPT-11) in mice. Anticancer Drugs 7:437–460PubMedCrossRef
3.
Zurück zum Zitat Boeck S, Heinemann V (2008) Second-line therapy in gemcitabine-pretreated patients with advanced pancreatic cancer. J Clin Oncol 26:1178–1179 author reply 1179PubMedCrossRef Boeck S, Heinemann V (2008) Second-line therapy in gemcitabine-pretreated patients with advanced pancreatic cancer. J Clin Oncol 26:1178–1179 author reply 1179PubMedCrossRef
4.
Zurück zum Zitat Burris HA III, Moore MJ, Andersen J, Green MR, Rothenberg ML, Modiano MR, Cripps MC, Portenoy RK, Storniolo AM, Tarassoff P, Nelson R, Dorr FA, Stephens CD, Von Hoff DD (1997) Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial. J Clin Oncol 15:2403–2413PubMed Burris HA III, Moore MJ, Andersen J, Green MR, Rothenberg ML, Modiano MR, Cripps MC, Portenoy RK, Storniolo AM, Tarassoff P, Nelson R, Dorr FA, Stephens CD, Von Hoff DD (1997) Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial. J Clin Oncol 15:2403–2413PubMed
5.
Zurück zum Zitat Creemers GJ, Lund B, Verweij J (1994) Topoisomerase I inhibitors: topotecan and irenotecan. Cancer Treat Rev 20:73–96PubMedCrossRef Creemers GJ, Lund B, Verweij J (1994) Topoisomerase I inhibitors: topotecan and irenotecan. Cancer Treat Rev 20:73–96PubMedCrossRef
6.
Zurück zum Zitat Douillard JY, Cunningham D, Roth AD, Navarro M, James RD, Karasek P, Jandik P, Iveson T, Carmichael J, Alakl M, Gruia G, Awad L, Rougier P (2000) Irinotecan combined with fluorouracil compared with fluorouracil alone as first-line treatment for metastatic colorectal cancer: a multicentre randomised trial. Lancet 355:1041–1047PubMedCrossRef Douillard JY, Cunningham D, Roth AD, Navarro M, James RD, Karasek P, Jandik P, Iveson T, Carmichael J, Alakl M, Gruia G, Awad L, Rougier P (2000) Irinotecan combined with fluorouracil compared with fluorouracil alone as first-line treatment for metastatic colorectal cancer: a multicentre randomised trial. Lancet 355:1041–1047PubMedCrossRef
7.
Zurück zum Zitat Ducreux M, Boige V, Malka D (2007) Treatment of advanced pancreatic cancer. Semin Oncol 34:S25–S30PubMedCrossRef Ducreux M, Boige V, Malka D (2007) Treatment of advanced pancreatic cancer. Semin Oncol 34:S25–S30PubMedCrossRef
8.
Zurück zum Zitat Fleming TR (1982) One-sample multiple testing procedure for phase II clinical trials. Biometrics 38:143–151PubMedCrossRef Fleming TR (1982) One-sample multiple testing procedure for phase II clinical trials. Biometrics 38:143–151PubMedCrossRef
9.
Zurück zum Zitat Kang SP, Saif MW (2008) Optimal second line treatment options for gemcitabine refractory advanced pancreatic cancer patients. Can we establish standard of care with available data? JOP 9:83–90PubMed Kang SP, Saif MW (2008) Optimal second line treatment options for gemcitabine refractory advanced pancreatic cancer patients. Can we establish standard of care with available data? JOP 9:83–90PubMed
10.
Zurück zum Zitat Kelly DM, Benjamin IS (1995) Pancreatic carcinoma. Ann Oncol 6:19–28PubMed Kelly DM, Benjamin IS (1995) Pancreatic carcinoma. Ann Oncol 6:19–28PubMed
11.
Zurück zum Zitat Klapdor R, Fenner C (2000) Irinotecan(Campto R): efficacy as third/forth line therapy in advanced pancreatic cancer. Anticancer Res 20:5209–5212PubMed Klapdor R, Fenner C (2000) Irinotecan(Campto R): efficacy as third/forth line therapy in advanced pancreatic cancer. Anticancer Res 20:5209–5212PubMed
12.
Zurück zum Zitat Rocha Lima CM, Green MR, Rotche R, Miller WH Jr, Jeffrey GM, Cisar LA, Morganti A, Orlando N, Gruia G, Miller LL (2004) 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 22:3776–3783PubMedCrossRef Rocha Lima CM, Green MR, Rotche R, Miller WH Jr, Jeffrey GM, Cisar LA, Morganti A, Orlando N, Gruia G, Miller LL (2004) 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 22:3776–3783PubMedCrossRef
13.
Zurück zum Zitat Saltz LB, Cox JV, Blanke C, Rosen LS, Fehrenbacher L, Moore MJ, Maroun JA, Ackland SP, Locker PK, Pirotta N, Elfring GL, Miller LL (2000) Irinotecan plus fluorouracil and leucovorin for metastatic colorectal cancer. Irinotecan Study Group. N Engl J Med 343:905–914PubMedCrossRef Saltz LB, Cox JV, Blanke C, Rosen LS, Fehrenbacher L, Moore MJ, Maroun JA, Ackland SP, Locker PK, Pirotta N, Elfring GL, Miller LL (2000) Irinotecan plus fluorouracil and leucovorin for metastatic colorectal cancer. Irinotecan Study Group. N Engl J Med 343:905–914PubMedCrossRef
14.
Zurück zum Zitat Stathopoulos GP, Syrigos K, Aravantinos G, Polyzos A, Papakotoulas P, Fountzilas G, Potamianou A, Ziras N, Boukovinas J, Varthalitis J, Androulakis N, Kotsakis A, Samonis G, Georgoulias V (2006) A multicenter phase III trial comparing irinotecan-gemcitabine (IG) with gemcitabine (G) monotherapy as first-line treatment in patients with locally advanced or metastatic pancreatic cancer. Br J Cancer 95:587–592PubMedCrossRef Stathopoulos GP, Syrigos K, Aravantinos G, Polyzos A, Papakotoulas P, Fountzilas G, Potamianou A, Ziras N, Boukovinas J, Varthalitis J, Androulakis N, Kotsakis A, Samonis G, Georgoulias V (2006) A multicenter phase III trial comparing irinotecan-gemcitabine (IG) with gemcitabine (G) monotherapy as first-line treatment in patients with locally advanced or metastatic pancreatic cancer. Br J Cancer 95:587–592PubMedCrossRef
15.
Zurück zum Zitat Taieb J, Lecomte T, Aparicio T, Asnacios A, Mansourbakht T, Artru P, Fallik D, Spano JP, Landi B, Lledo G, Desrame J (2007) FOLFIRI.3, a new regimen combining 5-fluorouracil, folinic acid and irinotecan, for advanced pancreatic cancer: results of an Association des Gastro-Enterologues Oncologues (Gastroenterologist Oncologist Association) multicenter phase II study. Ann Oncol 18:498–503PubMedCrossRef Taieb J, Lecomte T, Aparicio T, Asnacios A, Mansourbakht T, Artru P, Fallik D, Spano JP, Landi B, Lledo G, Desrame J (2007) FOLFIRI.3, a new regimen combining 5-fluorouracil, folinic acid and irinotecan, for advanced pancreatic cancer: results of an Association des Gastro-Enterologues Oncologues (Gastroenterologist Oncologist Association) multicenter phase II study. Ann Oncol 18:498–503PubMedCrossRef
16.
Zurück zum Zitat Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, Verweij J, Van Glabbeke M, van Oosterom AT, Christian MC, Gwyther SG (2000) New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 92:205–216PubMedCrossRef Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, Verweij J, Van Glabbeke M, van Oosterom AT, Christian MC, Gwyther SG (2000) New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 92:205–216PubMedCrossRef
17.
Zurück zum Zitat Ueno H, Okusaka T, Funakoshi A, Ishii H, Yamao K, Ishikawa O, Ohkawa S, Saitoh S (2007) A phase II study of weekly irinotecan as first-line therapy for patients with metastatic pancreatic cancer. Cancer Chemother Pharmacol 59:447–454PubMedCrossRef Ueno H, Okusaka T, Funakoshi A, Ishii H, Yamao K, Ishikawa O, Ohkawa S, Saitoh S (2007) A phase II study of weekly irinotecan as first-line therapy for patients with metastatic pancreatic cancer. Cancer Chemother Pharmacol 59:447–454PubMedCrossRef
18.
Zurück zum Zitat Ulrich-Pur H, Raderer M, Verena Kornek G, Schull B, Schmid K, Haider K, Kwasny W, Depisch D, Schneeweiss B, Lang F, Scheithauer W (2003) Irinotecan plus raltitrexed vs. raltitrexed alone in patients with gemcitabine-pretreated advanced pancreatic adenocarcinoma. Br J Cancer 88:1180–1184PubMedCrossRef Ulrich-Pur H, Raderer M, Verena Kornek G, Schull B, Schmid K, Haider K, Kwasny W, Depisch D, Schneeweiss B, Lang F, Scheithauer W (2003) Irinotecan plus raltitrexed vs. raltitrexed alone in patients with gemcitabine-pretreated advanced pancreatic adenocarcinoma. Br J Cancer 88:1180–1184PubMedCrossRef
19.
Zurück zum Zitat Wagener DJ, Verdonk HE, Dirix LY, Catimel G, Siegenthaler P, Buitenhuis M, Mathieu-Boue A, Verweij J (1995) Phase II trial of CPT-11 in patients with advanced pancreatic cancer, an EORTC early clinical trials group study. Ann Oncol 6:129–132PubMed Wagener DJ, Verdonk HE, Dirix LY, Catimel G, Siegenthaler P, Buitenhuis M, Mathieu-Boue A, Verweij J (1995) Phase II trial of CPT-11 in patients with advanced pancreatic cancer, an EORTC early clinical trials group study. Ann Oncol 6:129–132PubMed
Metadaten
Titel
Irinotecan monotherapy as second-line treatment in advanced pancreatic cancer
verfasst von
Seong Yoon Yi
Young Suk Park
Hyo Song Kim
Hyun Jung Jun
Kyoung Ha Kim
Myung Hee Chang
Min Jae Park
Ji Eun Uhm
Jeeyun Lee
Se Hoon Park
Joon Oh Park
Jong Kyun Lee
Kyu Taek Lee
Ho Yeong Lim
Won Ki Kang
Publikationsdatum
01.05.2009
Verlag
Springer-Verlag
Erschienen in
Cancer Chemotherapy and Pharmacology / Ausgabe 6/2009
Print ISSN: 0344-5704
Elektronische ISSN: 1432-0843
DOI
https://doi.org/10.1007/s00280-008-0839-y

Weitere Artikel der Ausgabe 6/2009

Cancer Chemotherapy and Pharmacology 6/2009 Zur Ausgabe

Umsetzung der POMGAT-Leitlinie läuft

03.05.2024 DCK 2024 Kongressbericht

Seit November 2023 gibt es evidenzbasierte Empfehlungen zum perioperativen Management bei gastrointestinalen Tumoren (POMGAT) auf S3-Niveau. Vieles wird schon entsprechend der Empfehlungen durchgeführt. Wo es im Alltag noch hapert, zeigt eine Umfrage in einem Klinikverbund.

CUP-Syndrom: Künstliche Intelligenz kann Primärtumor finden

30.04.2024 Künstliche Intelligenz Nachrichten

Krebserkrankungen unbekannten Ursprungs (CUP) sind eine diagnostische Herausforderung. KI-Systeme können Pathologen dabei unterstützen, zytologische Bilder zu interpretieren, um den Primärtumor zu lokalisieren.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Adjuvante Immuntherapie verlängert Leben bei RCC

25.04.2024 Nierenkarzinom Nachrichten

Nun gibt es auch Resultate zum Gesamtüberleben: Eine adjuvante Pembrolizumab-Therapie konnte in einer Phase-3-Studie das Leben von Menschen mit Nierenzellkarzinom deutlich verlängern. Die Sterberate war im Vergleich zu Placebo um 38% geringer.

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.