Treatment of advanced pancreatic carcinoma with a combination of protracted infusional 5-fluorouracil and weekly carboplatin: A Mid-Atlantic Oncology Program study

Background: Advanced pancreatic cancer is a rapidly fatal disease whosecourse has been little influenced by chemotherapy. Earlier studies have shownsome modest promise for the combination of protracted infusional5-fluorouracil (PIF)and cisplatin. We sought to evaluate a regimen of possibly lesser toxicity,PIF plus weekly carboplatin.Patients and methods: Fifty-four patients with advanced adenocarcinoma ofthe pancreas were treated with a regimen of protracted infusional fluorouracil300 mg/m²/day for 70 days and carboplatin 100mg/m²/weekly on weeks 1 through 10 of a 12-week cycle. Aftera two-week rest, cycles were repeated until progression.Results: Median duration on treatment was 82 days (range 4–490 days).Toxicity was mild. Grade 3–4 toxicities were anemia 11%,leukopenia 6%, thrombocytopenia 2%, nausea/vomiting 7%,diarrhea 9%, mucositis 9%, and renal 2%. Response wasevaluable in 47 patients. There were two complete and seven partial responses(17% overall objective response rate among all patients). Stabledisease for greater than 12 weeks was seen in 19 patients (40%) andprogression in 19 (40%). The median overall survival was 22 weeks(1–99), with 61 weeks median survival in responders (22–99).One-year survival was 13%.Conclusions: Response and survival results with this regimen are at leastequal to the best combination regimens reported, and were obtained with a lowoverall rate of serious toxicity.