Gemcitabine and cisplatin in the treatment of advanced or metastatic pancreatic cancer

Background: This phase II study was initiated to determine the efficacy and safety of gemcitabine plus cisplatin in patients with pancreatic cancer. Patients and methods: Gemcitabine 1000 mg/m(2) was given on days 1, 8, and 15 of a 28-day schedule, and cisplatin 50 mg/m(2) on days 1 and 15 to chemonaive patients with locally advanced or metastatic pancreatic cancer. Results: Of the 41 patients enrolled (median age 57, and 61% male), median Karnofsky performance status was 80%. Patients received a median of 4.2 cycles (range 1-11). In 35 evaluable patients, one complete response (CR) and three partial responses (PR) were observed, for an overall response rate of 11% (95% confidence interval (95% CI): 3.2%-26.7%). Stable disease (SD) >3 months occurred in 20 (57%) patients; 6 survived greater than or equal to1 year. Median time to progressive disease was 4.3 months (95% CI: 3.0-5.7 months). For all patients, median survival was 8.2 months (95% CI: 6.1-10.6 months) with a one-year survival rate of 27%. Therapy was well tolerated. Grade 3-4 neutropenia (no grade 3-4 infection), thrombocytopenia (no bleeding), nausea/vomiting, and alopecia were reported in 29%, 13%, and 2.6% of patients, respectively. Conclusions: The combination of gemcitabine and cisplatin is a moderately active treatment for patients with locally advanced and metastatic pancreatic cancer without compromising tolerability.