Phase II trial of PALA in combination with 5-fluorouracil in advanced pancreatic cancer |
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| Authors: | Elizabeth Rosyold Russell Schilder Judy Walczak S M DiFino P J Flynn T K Banerjee W J Heim Paul E Engstrom Robert F Ozols Peter J O'Dwyer |
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| Institution: | (1) Syracuse Hematology/Oncology CCOP, Syracuse, New York, USA;(2) West Metro-Minneapolis CCOP, St. Louis Park, Minnesta, USA;(3) Marshfield Clinic, Marshfield, Wisconsin, USA;(4) Mercy Hospital Scranton, Pennsylvania, USA;(5) Department of Medical Oncology, Fox Chase Cancer Center, 7701 Burholme Avenue, 19111 Philadelphia, PA, USA |
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| Abstract: | Summary Phosphonacetyl-l-aspartate (PALA), an inhibitor of aspartate transcarbamylase that depletes uridine nucleotide pools, selectively potentiates the antitumor activity of 5-fluorouracil (5-FU) in preclinical models. Due to the promising results we obtained using PALA/5-FU in colorectal cancer, we performed a phase II trial in patients presenting with advanced pancreatic cancer. PALA was given intravenously at 250 mg/m2 on day 1, followed 24 h later by 2,600 mg/m2 5-FU given by 24-h infusion. Treatments were repeated weekly. A total of 41 patients who had not previously undergone chemotherapy were entered in the trial; of these, 35 were evaluable for response. Toxicity was generally mild to moderate; neurotoxicity (13/35) and diarrhea (8/35) predominated. Among the 35 patients, 1 achieved a complete response and 4, a partial remission, for an overall response rate of 14%. The median survival was 5.1 months. Pretreatment with PALA alone was not sufficient to enhance the activity of 5-FU in pancreatic cancer.Supported in part by grant CA 06927 from the National Cancer Institute |
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