pancreas diseases : New Study of Gemcitabine, Cisplatin and Bevacizumab Yields Promising Results

According to results reported by Andrew Ko, MD (University of California, San Francisco), an experimental protocol including gemcitabine, cisplatin and the molecular targeting agent bevacizumab (Avastin) yielded astonishing results in patients with metastatic pancreatic cancer. In this single institution phase II study, patients were given gemcitabine 1000mg/m2, cisplatin 20 mg/m2 and bevacizumab 10 mg/kg on days 1 and 15 of a 28-day cycle. CT scans were performed every two cycles. Of the 35 patients enrolled, 66.7% achieved disease control (complete response > one year: 1; partial response: 6; stable disease: 15). Median survival, evaluated after 28 days, was 8 months for the cohort as a whole, the estimated 1-year survival being 39%. Dr. Ko drew attention to the fact that all patients in the study had either been diagnosed when the disease was already metastatic or had cancer recurrence after a Whipple procedure. ’The combination of fixed-dose rate gemcitabine, low-dose cisplatin and bevacizumab appears to be very active in patients with metastatic pancreatic cancer’, Dr. Ko said. ‘However’, he cautioned, ‘the potential benefits of this regimen need to be carefully weighed against the considerable toxicity observed on the study.’ Indeed, the complications were considerable: About 25% of patients developed grade 3 or worse liver toxicity; 11% developed hypertension, and major bleeding events occurred in 8.6% of patients. Two patients had bowel perforation, and 1 person suffered a stroke-like event. Better patient selection, such as excluding those with tumors that were protruding through organ walls, might reduce some of these complications, Dr. Ko said. These results were presented during the 3rd Gastrointestinal Cancers Symposium (ASCO-GI) held in San Francisco, CA, January 20 - 30, 2006.

PancreasWeb 03/02/06