Weekly Paclitaxel After Failure of Gemcitabine in Pancreatic Cancer Patients with Malignant Ascites: A Retrospective Study

Division of Gastrointestinal Oncology, Shizuoka Cancer Center, 1007, Nagaizumi, Shizuoka 411-8777, Japan.
Japanese Journal of Clinical Oncology (Impact Factor: 2.02). 12/2010; 40(12):1135-8. DOI: 10.1093/jjco/hyq117
Source: PubMed


Peritoneal metastasis is one of the major sites of disease progression of pancreatic cancer. There have been few trials in the second-line setting after gemcitabine failure because patients can hardly be candidates for chemotherapy after failure in the first-line chemotherapy, especially those with malignant ascites. The safety and efficacy of weekly paclitaxel therapy was evaluated for pancreatic cancer patients with malignant ascites in this retrospective study.
The subjects of this retrospective study were 23 advanced pancreatic cancer patients with malignant ascites who received weekly paclitaxel therapy after gemcitabine failure. Paclitaxel (80 mg/m(2), div. for 1 h) was administered on Days 1, 8 and 15, every 4 weeks.
While the disease control rate was 35%, decrease of ascites was obtained in 30% of the patients and ascites control rate was 61%. The median survival time was 101 days. Toxicities were mild, although one treatment-related death occurred.
Weekly paclitaxel therapy may be useful treatment option for pancreatic cancer patients with malignant ascites after gemcitabine failure.

9 Reads
  • Source
    • "Paclitaxel is a semisynthetic taxane that interferes with mitotic spindles, inhibits the depolymerization of microtubules and blocks the mitotic cell cycle [6]. Recently, 3 reports of second-line chemotherapy using paclitaxel for advanced pancreatic cancer refractory to GEM or GEM-based regimens have been published, 2 with weekly administration of paclitaxel [7, 8], and 1 with a 5-FU/paclitaxel combination [9]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Gemcitabine (GEM) is a gold-standard chemotherapy agent for advanced pancreatic cancer. Because of the malignant character of the disease, nearly all patients show disease progression despite treatment with GEM-based chemotherapy; therefore, second-line chemotherapy may be beneficial for these patients. We report a retrospective analysis of 5 patients with advanced pancreatic cancer, treated with a paclitaxel-containing regimen as second-, third- or fourth-line chemotherapy after various therapies, such as a GEM-based regimen, S-1 regimen, and chemoradiation. We retrospectively analyzed the efficacy and adverse events, and evaluated the paclitaxel-containing regimens. A review of the literature is also discussed. The median overall survival from the start of salvage therapy was 10.7 months. The disease control rate of the paclitaxel-containing regimen according to RECIST criteria was 60%, including complete response in 0 patients, partial response in 3, and stable disease in 2. Two patients had malignant ascites at the start of this salvage therapy, and in both of them the ascites and clinical complaints improved. Grade 3 and 4 hematological adverse events were observed in 2 patients and 1 patient, respectively. Salvage paclitaxel-based therapy could be beneficial to advanced pancreatic cancer patients who maintain good performance status after several chemotherapy failures.
    Case Reports in Oncology 09/2011; 4(3):534-41. DOI:10.1159/000334704
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Pomegranate extract (PE) is a standardized whole-fruit extract of pomegranate, a fruit with known anticancer properties. PANC-1 and AsPC-1 human pancreatic cancer cells were used as in vitro models to test the effects of PE. PE treatment induced cell cycle arrest and inhibited cell proliferation in PANC-1 cells. PE treatment increased the proportion of cells lacking CD44 and CD24 expression, which are associated with increased tumor-initiating ability, demonstrating that PE altered cell phenotype. PE was more effective in inhibiting the proliferation of PANC-1 cells than the clinically used dose of paclitaxel. Similar results were obtained in the AsPC-1 cell line. Individual pomegranate phytochemicals were only modestly effective in inhibiting cell proliferation, suggesting that unidentified phytochemicals are responsible for the inhibitory effect of PE. These data suggest that PE is a promising candidate for further preclinical testing for treatment of human pancreatic cancer.
    Anticancer research 09/2011; 31(9):2699-704. · 1.83 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: A 5 5-year-old woman was admitted to our hospital for pancreatic cancer with liver metastasis. We performed pancreatoduodenectomy, D2 dissection, and partial liver resection. Tissue from a resected liver metastasis was submitted to a chemosensitivity test. Based on the test results, we performed systemic chemotherapy with paclitaxel and hepatic artery infusion with gemcitabine for lung and liver metastasis after surgery. Furthermore, we added stereotactic body radiation therapy(SBRT)(48 Gy/4 Fr)for 3 liver metastases that showed enlargement after chemotherapy. Effective control of recurrent tumors was possible for 2 years and 5 month, and she maintained normal daily activities. She died of peritoneal dissemination 3 years and one month after surgery. Combined modality therapy with anticancer agents based on a chemosensitivity test and SBRT may be one useful therapy for pancreatic cancer with distant metastases.
    Gan to kagaku ryoho. Cancer & chemotherapy 03/2012; 39(3):481-3.
Show more