Paclitaxel as second-line chemotherapy in patients with gemcitabine-refractory pancreatic cancer: A retrospective study

Shimpei Maeda, Fuyuhiko Motoi, Tohru Onogawa, Takanori Morikawa, Ottomo Shigeru, Naoaki Sakata, Tatsuyuki Takadate, Takeshi Naito, Toshiki Rikiyama, Yu Katayose, Shinichi Egawa, Michiaki Unno

Research output: Contribution to journalArticlepeer-review

24 Citations (Scopus)

Abstract

Background: We evaluated the efficacy and feasibility of paclitaxel in patients with gemcitabine-refractory pancreatic cancer. We also evaluated the correlation between tumor marker decline and response rate. Methods: Thirty patients histologically diagnosed with pancreatic cancer who had undergone paclitaxel treatment as salvage chemotherapy were retrospectively analyzed. Paclitaxel treatment was performed with 80 mg/(m 2 week) for 3 weeks followed by 1 week rest, and this was continued until failure. Tumor marker response was evaluated by measuring levels of carbohydrate antigen 19-9, carcinoembryonic antigen, and DUPAN-2 monthly. Results: In total, 272 weekly paclitaxel treatments were performed. The median number of treatments per patient was 8 (range 1-22). The median overall survival from the start of paclitaxel treatment was 6.7 months (range 1.2-18.8). The response rate was 10% (3/30 patients) and the disease control rate was 46.7% (14/30 patients). Although grade 3 and 4 hematological and non-hematological toxicities were seen in 7 and 6 patients, respectively, adverse events were managed by conservative treatment. We found a significant correlation between the disease control rate and tumor marker decline within 2 months of paclitaxel treatment (P = 0.01). Patients with tumor marker decline tended to survive longer. Conclusion: Weekly administration of paclitaxel in patients with gemcitabine-refractory pancreatic cancer seems to be well tolerated and can be effective. Paclitaxel treatment should be considered as salvage chemotherapy after gemcitabine failure in patients with good performance status.

Original languageEnglish
Pages (from-to)539-545
Number of pages7
JournalInternational Journal of Clinical Oncology
Volume16
Issue number5
DOIs
Publication statusPublished - 2011 Oct

Keywords

  • Gemcitabine
  • Paclitaxel
  • Pancreatic cancer
  • Second-line chemotherapy

ASJC Scopus subject areas

  • Surgery
  • Hematology
  • Oncology

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