Open-label trial on efficacy and security of treatment with gemcitabine and oral modulation with tegafur and levofolinic acid (GEMTG) in patients with advanced pancreatic cancer

AIM: Advanced pancreatic cancer has a bad prognosis, with a median overall survival (OS) no longer than 4-6 months. Since the end of last century, monotherapy with gemcitabine has remained the elective therapy, but new schedules are needed in order to improve these results. We aim to evaluate the efficacy of tegafur and levofolinic acid (LV) associated with gemcitabine, as well as its toxicity, progression-free survival and OS in advanced pancreatic cancer. PATIENTS AND METHODS: An open-label, multicentric, prospective, non-controlled trial was carried out on patients with advanced or disseminated pancreatic cancer. Gemcitabine 1250 mg/m² was administered on the 1st and 8th days of the cycle, tegafur 750 mg/m²/day for 21 consecutive days and LV 25 mg/day continuously, every 28 days, with a maximum of six cycles. The primary variable was tumour overall response rate (ORR). Secondarily, time to progression (TTP), OS and scheme toxicity were determined. RESULTS: Forty patients were recruited; the male/female ratio was 30:10, with a mean age of 61 years. Forty percent had a Karnofsky index of 90% or 100%. Only 11 patients (27%) completed the six cycles of treatment, but more than 50% received three or more cycles. Dose intensity was 89.56% for gemcitabine and 87.36% for tegafur. Efficacy ORR was 22.5% (CI 95%, 6-37%). TTP was 3.87 months (CI 95%, 2.1-5.6), time to treatment failure was 2.97 months (CI 95%, 2.43-4.67) and OS 6.3 months (CI 95%, 4-7). The chemotherapeutic combination was well accepted; most haematologic and non-haematologic toxicities were grade 1 or 2. The most prevalent grade 3/4 toxicities were asthenia (30%), liver biochemistry disorders (25%), diarrhoea (15%) and stomatitis (12%). CONCLUSIONS: The administration of gemcitabine, associated with oral tegafur and leucovorin, has activity against advanced pancreatic cancer, with an adequate toxicity profile (AU)

Síndrome RS3PE como primera manifestación de carcinoma prostático / RS3PE syndrome as a first manifestation of prostatic carcinoma

No disponible

[Treatment of inflammatory cancer of the breast. Combined chemotherapy and radiotherapy. Apropos of 270 women treated at the Institut Gustave-Roussy]. / Le traitement du cancer du sein inflammatoire. Associations chimiothérapie-radiothérapie. A propos de 270 femmes traitées à l'Institut Gustave-Roussy.

From January 1976 to January 1985, 210 patients (less than 70 years old) with unilateral inflammatory breast carcinoma M0 were treated, under protocol way, by chemotherapy, hormonotherapy and radiotherapy association. Results of these protocols are compared to those of an historical control group T (60 patients treated from 1973 to 1975 by radiotherapy alone, with castration for pre-menopausal women). From 1976 to 1980, 91 patients (group A) were treated by induction chemotherapy first with adriamycin, vincristine and methotrexate (AVM), loco-regional radiotherapy and maintenance chemotherapy with vincristine, cyclophosphamide and 5 fluorouracil (VCF). From 1980 to 1982, 79 patients (group B) were treated under a similar protocol, but the 3 first sequences were reinforced with the association of five drugs: adriamycin, vincristine, cyclophosphamide, methotrexate, 5 FU (AVCMF). From 1983 to 1985, 40 patients (group C) were treated under the same schedule AVCMF, AVM, VCF, but radiotherapy was delivered on a different schedule to shorten the intervals between the 3, 4, 5 and 6th chemotherapy sequences. All patients form the groups A, B and C had received hormonotherapy: castration for premenopausal patients or on-going menopause, or tamoxifen for post-menopausal patients. Disease-free survival rates at 30 months are respectively 19, 37, 61 and 64% for groups T, A, B and C and for groups T, A and B: 8, 22 and 40% at 5 years, and total survival rates at 5 years: 28, 40 and 55% for these groups. The benefit of chemotherapy in addition to radiotherapy is highly statistically significant. The improvement of these results seems partially linked to the increasing dosage of the induction chemotherapy.