Abstract
Background. Chemotherapeutic treatments using combinations of etoposide, leucovorin and 5-FU (ELF) have shown activity in the treatment of gastrointestinal malignancies. Interferon alpha 2b is known to have antiproliferative effects on several cell lines and has well documented in vitro evidence of synergism with 5-FU. It was postulated that the combination of ELF and interferon alpha 2b would improve response rates and survival in patients with pancreas cancer. Methods. Fifty-five eligible patients with locally-advanced or metastatic pancreatic adenocarcinoma received a regimen consisting of: IV leucovorin at 300 mg/m2/day on Days 1-3 (of 28-day cycle), IV etoposide at 80 mg/m2/day on Days 1-3, IV 5-FU at 500 mg/m2/day on Days 1-3, subcutaneous interferon alpha 2b at 3 million units TIW, and subcutaneous G-CSF at 5 μg/kg/day on Days 4-14 (or until WBC exceeds 10,000/μl). Patients with no evidence of disease progression continued on treatment for a total of 6 cycles. Results. Complete response was demonstrated in 1 patient, partial response in 5 patients (11% confirmed response rate). The median survival was 5 months, and the six-month survival rate was 40%. Ten patients completed all 6 cycles of treatment. Toxicity-related dose delays and reductions were necessary for most patients. Conclusions. Although the combination of ELF and interferon alpha 2b (ELFI) has modest activity in pancreatic cancer, it is a toxic and complex regimen that is not superior to other currently available approaches for the chemotherapeutic management of pancreatic cancer. ELFI cannot be recommended as a standard therapy.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 269-273 |
| Number of pages | 5 |
| Journal | Investigational New Drugs |
| Volume | 18 |
| Issue number | 3 |
| DOIs | |
| State | Published - 2000 |
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Keywords
- 5-fluorouracil
- Combination chemotherapy
- Etoposide
- Interferon alpha
- Pancreatic cancer
ASJC Scopus subject areas
- Molecular Medicine
- Pharmacology
Cite this
A phase II trial of etoposide, leucovorin, 5-FU, and interferon alpha 2b (ELFI) + G-CSF for patients with pancreatic adenocarcinoma : A Southwest Oncology Group study (SWOG 9413). / Macdonald, John S.; Jacobson, Joth L.; Modiano, Manuel; Moore, Dennis F.; Gandara, David R; Schroder, Louis E.; Chapman, Robert A.
In: Investigational New Drugs, Vol. 18, No. 3, 2000, p. 269-273.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A phase II trial of etoposide, leucovorin, 5-FU, and interferon alpha 2b (ELFI) + G-CSF for patients with pancreatic adenocarcinoma
T2 - A Southwest Oncology Group study (SWOG 9413)
AU - Macdonald, John S.
AU - Jacobson, Joth L.
AU - Modiano, Manuel
AU - Moore, Dennis F.
AU - Gandara, David R
AU - Schroder, Louis E.
AU - Chapman, Robert A.
PY - 2000
Y1 - 2000
N2 - Background. Chemotherapeutic treatments using combinations of etoposide, leucovorin and 5-FU (ELF) have shown activity in the treatment of gastrointestinal malignancies. Interferon alpha 2b is known to have antiproliferative effects on several cell lines and has well documented in vitro evidence of synergism with 5-FU. It was postulated that the combination of ELF and interferon alpha 2b would improve response rates and survival in patients with pancreas cancer. Methods. Fifty-five eligible patients with locally-advanced or metastatic pancreatic adenocarcinoma received a regimen consisting of: IV leucovorin at 300 mg/m2/day on Days 1-3 (of 28-day cycle), IV etoposide at 80 mg/m2/day on Days 1-3, IV 5-FU at 500 mg/m2/day on Days 1-3, subcutaneous interferon alpha 2b at 3 million units TIW, and subcutaneous G-CSF at 5 μg/kg/day on Days 4-14 (or until WBC exceeds 10,000/μl). Patients with no evidence of disease progression continued on treatment for a total of 6 cycles. Results. Complete response was demonstrated in 1 patient, partial response in 5 patients (11% confirmed response rate). The median survival was 5 months, and the six-month survival rate was 40%. Ten patients completed all 6 cycles of treatment. Toxicity-related dose delays and reductions were necessary for most patients. Conclusions. Although the combination of ELF and interferon alpha 2b (ELFI) has modest activity in pancreatic cancer, it is a toxic and complex regimen that is not superior to other currently available approaches for the chemotherapeutic management of pancreatic cancer. ELFI cannot be recommended as a standard therapy.
AB - Background. Chemotherapeutic treatments using combinations of etoposide, leucovorin and 5-FU (ELF) have shown activity in the treatment of gastrointestinal malignancies. Interferon alpha 2b is known to have antiproliferative effects on several cell lines and has well documented in vitro evidence of synergism with 5-FU. It was postulated that the combination of ELF and interferon alpha 2b would improve response rates and survival in patients with pancreas cancer. Methods. Fifty-five eligible patients with locally-advanced or metastatic pancreatic adenocarcinoma received a regimen consisting of: IV leucovorin at 300 mg/m2/day on Days 1-3 (of 28-day cycle), IV etoposide at 80 mg/m2/day on Days 1-3, IV 5-FU at 500 mg/m2/day on Days 1-3, subcutaneous interferon alpha 2b at 3 million units TIW, and subcutaneous G-CSF at 5 μg/kg/day on Days 4-14 (or until WBC exceeds 10,000/μl). Patients with no evidence of disease progression continued on treatment for a total of 6 cycles. Results. Complete response was demonstrated in 1 patient, partial response in 5 patients (11% confirmed response rate). The median survival was 5 months, and the six-month survival rate was 40%. Ten patients completed all 6 cycles of treatment. Toxicity-related dose delays and reductions were necessary for most patients. Conclusions. Although the combination of ELF and interferon alpha 2b (ELFI) has modest activity in pancreatic cancer, it is a toxic and complex regimen that is not superior to other currently available approaches for the chemotherapeutic management of pancreatic cancer. ELFI cannot be recommended as a standard therapy.
KW - 5-fluorouracil
KW - Combination chemotherapy
KW - Etoposide
KW - Interferon alpha
KW - Pancreatic cancer
UR - http://www.scopus.com/inward/record.url?scp=0033879660&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0033879660&partnerID=8YFLogxK
U2 - 10.1023/A:1006486025196
DO - 10.1023/A:1006486025196
M3 - Article
C2 - 10958597
AN - SCOPUS:0033879660
VL - 18
SP - 269
EP - 273
JO - Investigational New Drugs
JF - Investigational New Drugs
SN - 0167-6997
IS - 3
ER -