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In a Phase III study, the addition of the chemotherapy drug Eloxatin® (oxaliplatin) to the chemotherapy regimen of folinic acid and fluorouracil (5-FU) improved outcomes in patients with advanced pancreatic cancer that had progressed on Gemzar® (gemcitabine). These findings were recently published in Journal of Clinical Oncology.

Pancreatic cancer is one of the deadliest forms of cancer. Each year, approximately 43,000 people are diagnosed with pancreatic cancer in the United States and close to 37,000 die from the disease. The disease is often diagnosed at an advanced stage, and treatment of advanced disease remains challenging.

Gemzar has been a standard chemotherapy drug for the treatment of advanced pancreatic cancer for some time. Not all pancreatic cancers, however, respond to treatment with Gemzar.

To explore therapeutic options for patients with advanced pancreatic cancer that has progressed on Gemzar, German researchers evaluated two treatment combinations: Eloxatin plus folinic acid and 5-FU and folinic acid and 5-FU without Eloxatin.

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Participants included almost 170 patients with advanced pancreatic cancer who had been previously treatment with Gemzar, but whose disease had still progressed. The researchers began recruiting patients for the study in 2004 and followed up with them through 2012. Participants were split into two treatment groups; one received folinic acid and 5-FU, while the other received folinic acid and 5-FU plus Eloxatin.

At a median follow-up of 4.5 years, survival was higher among patients receiving Eloxatin—almost six months versus just over three months. Patients in the Eloxatin group also had a longer interval before cancer progressed—almost three months versus two months. Side effects between both treatment groups were generally similar, though patients receiving Eloxatin experienced five times the rate of neurotoxicity (effects to the nervous system)—29 versus six patients.

The researchers concluded that folinic acid and 5-FU plus Eloxatin might be an effective treatment option for patients with advanced pancreatic cancer that has progressed on Gemzar. The combination has demonstrated better outcomes than folinic acid and 5-FU alone and is acceptably safe.

Reference: Oettle H, Riess H, Stieler JM, et al. Second-Line Oxaliplatin, Folinic Acid, and Fluorouracil Versus Folinic Acid and Fluorouracil Alone for Gemcitabine-Refractory Pancreatic Cancer: Outcomes From the CONKO-003 Trial. Journal of Clinical Oncology [early online publication]. June 30, 2014.

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