Gemcitabine as first-line chemotherapy in elderly patients with unresectable pancreatic carcinoma

Yoshiyuki Yamagishi, Hajime Higuchi, Motoko Izumiya, Gen Sakai, Hideko Iizuka, Shoko Nakamura, Masayuki Adachi, Shigenari Hozawa, Hiromasa Takaishi, Toshifumi Hibi

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Abstract

Gemcitabine (GEM) is the key drug for the chemotherapy of unresectable pancreatic cancer. However, the efficacy and safety of GEM has not been established in elderly patients. We retrospectively examined the prognosis of elderly pancreatic cancer patients treated with GEM. Methods Sixty-six patients with unresectable pancreatic cancer (pathologically identified) and no prior chemotherapy were divided into three groups. Group A: patients aged 70 years or more who received standard GEM (1000 mg/m2) on days 1, 8, and 15 and rest on day 21; Group B: patients less than 70 years old who received standard GEM therapy; and Group C: patients under best supportive care. Results Median survival times (MSTs) (days) were 311 in group A (p<0.05 vs. group C), 292 in group B (p<0.05 vs. group C), and 127 in group C.Amongthe patientswho received GEM, 23% patients in group A and 16% patients in group B obtained partial responses. The response rates andMSTs were similar in groupsAandB, aswell as in more aged (≥75 years) patients. Bone marrow suppression was more frequently seen in elderly patients. Cox's hazard model in patients aged 70 years or more revealed that GEM therapy reduced the hazard ratio for death (hazard ratio: 0.683, p = 0.041). Conclusions Chemotherapy with GEM appears to be effective and safe in elderly patients as well as in younger patients. Patients with unresectable pancreatic carcinoma should receive GEM therapy even if they are aged 70 or more, even if they are aged 75 or more.

Original languageEnglish
Pages (from-to)1146-1154
Number of pages9
JournalJournal of Gastroenterology
Volume45
Issue number11
DOIs
Publication statusPublished - 2010 Nov

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gemcitabine
Drug Therapy
Pancreatic Neoplasms
Pancreatic Carcinoma
Proportional Hazards Models

Keywords

  • CA19-9
  • Dupan-2
  • Elderly
  • Gemcitabine
  • Neoplasm
  • Pancreas
  • Unresectable

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Yamagishi, Y., Higuchi, H., Izumiya, M., Sakai, G., Iizuka, H., Nakamura, S., ... Hibi, T. (2010). Gemcitabine as first-line chemotherapy in elderly patients with unresectable pancreatic carcinoma. Journal of Gastroenterology, 45(11), 1146-1154. https://doi.org/10.1007/s00535-010-0258-9

Gemcitabine as first-line chemotherapy in elderly patients with unresectable pancreatic carcinoma. / Yamagishi, Yoshiyuki; Higuchi, Hajime; Izumiya, Motoko; Sakai, Gen; Iizuka, Hideko; Nakamura, Shoko; Adachi, Masayuki; Hozawa, Shigenari; Takaishi, Hiromasa; Hibi, Toshifumi.

In: Journal of Gastroenterology, Vol. 45, No. 11, 11.2010, p. 1146-1154.

Research output: Contribution to journalArticle

Yamagishi, Y, Higuchi, H, Izumiya, M, Sakai, G, Iizuka, H, Nakamura, S, Adachi, M, Hozawa, S, Takaishi, H & Hibi, T 2010, 'Gemcitabine as first-line chemotherapy in elderly patients with unresectable pancreatic carcinoma', Journal of Gastroenterology, vol. 45, no. 11, pp. 1146-1154. https://doi.org/10.1007/s00535-010-0258-9
Yamagishi, Yoshiyuki ; Higuchi, Hajime ; Izumiya, Motoko ; Sakai, Gen ; Iizuka, Hideko ; Nakamura, Shoko ; Adachi, Masayuki ; Hozawa, Shigenari ; Takaishi, Hiromasa ; Hibi, Toshifumi. / Gemcitabine as first-line chemotherapy in elderly patients with unresectable pancreatic carcinoma. In: Journal of Gastroenterology. 2010 ; Vol. 45, No. 11. pp. 1146-1154.
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abstract = "Gemcitabine (GEM) is the key drug for the chemotherapy of unresectable pancreatic cancer. However, the efficacy and safety of GEM has not been established in elderly patients. We retrospectively examined the prognosis of elderly pancreatic cancer patients treated with GEM. Methods Sixty-six patients with unresectable pancreatic cancer (pathologically identified) and no prior chemotherapy were divided into three groups. Group A: patients aged 70 years or more who received standard GEM (1000 mg/m2) on days 1, 8, and 15 and rest on day 21; Group B: patients less than 70 years old who received standard GEM therapy; and Group C: patients under best supportive care. Results Median survival times (MSTs) (days) were 311 in group A (p<0.05 vs. group C), 292 in group B (p<0.05 vs. group C), and 127 in group C.Amongthe patientswho received GEM, 23{\%} patients in group A and 16{\%} patients in group B obtained partial responses. The response rates andMSTs were similar in groupsAandB, aswell as in more aged (≥75 years) patients. Bone marrow suppression was more frequently seen in elderly patients. Cox's hazard model in patients aged 70 years or more revealed that GEM therapy reduced the hazard ratio for death (hazard ratio: 0.683, p = 0.041). Conclusions Chemotherapy with GEM appears to be effective and safe in elderly patients as well as in younger patients. Patients with unresectable pancreatic carcinoma should receive GEM therapy even if they are aged 70 or more, even if they are aged 75 or more.",
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T1 - Gemcitabine as first-line chemotherapy in elderly patients with unresectable pancreatic carcinoma

AU - Yamagishi, Yoshiyuki

AU - Higuchi, Hajime

AU - Izumiya, Motoko

AU - Sakai, Gen

AU - Iizuka, Hideko

AU - Nakamura, Shoko

AU - Adachi, Masayuki

AU - Hozawa, Shigenari

AU - Takaishi, Hiromasa

AU - Hibi, Toshifumi

PY - 2010/11

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N2 - Gemcitabine (GEM) is the key drug for the chemotherapy of unresectable pancreatic cancer. However, the efficacy and safety of GEM has not been established in elderly patients. We retrospectively examined the prognosis of elderly pancreatic cancer patients treated with GEM. Methods Sixty-six patients with unresectable pancreatic cancer (pathologically identified) and no prior chemotherapy were divided into three groups. Group A: patients aged 70 years or more who received standard GEM (1000 mg/m2) on days 1, 8, and 15 and rest on day 21; Group B: patients less than 70 years old who received standard GEM therapy; and Group C: patients under best supportive care. Results Median survival times (MSTs) (days) were 311 in group A (p<0.05 vs. group C), 292 in group B (p<0.05 vs. group C), and 127 in group C.Amongthe patientswho received GEM, 23% patients in group A and 16% patients in group B obtained partial responses. The response rates andMSTs were similar in groupsAandB, aswell as in more aged (≥75 years) patients. Bone marrow suppression was more frequently seen in elderly patients. Cox's hazard model in patients aged 70 years or more revealed that GEM therapy reduced the hazard ratio for death (hazard ratio: 0.683, p = 0.041). Conclusions Chemotherapy with GEM appears to be effective and safe in elderly patients as well as in younger patients. Patients with unresectable pancreatic carcinoma should receive GEM therapy even if they are aged 70 or more, even if they are aged 75 or more.

AB - Gemcitabine (GEM) is the key drug for the chemotherapy of unresectable pancreatic cancer. However, the efficacy and safety of GEM has not been established in elderly patients. We retrospectively examined the prognosis of elderly pancreatic cancer patients treated with GEM. Methods Sixty-six patients with unresectable pancreatic cancer (pathologically identified) and no prior chemotherapy were divided into three groups. Group A: patients aged 70 years or more who received standard GEM (1000 mg/m2) on days 1, 8, and 15 and rest on day 21; Group B: patients less than 70 years old who received standard GEM therapy; and Group C: patients under best supportive care. Results Median survival times (MSTs) (days) were 311 in group A (p<0.05 vs. group C), 292 in group B (p<0.05 vs. group C), and 127 in group C.Amongthe patientswho received GEM, 23% patients in group A and 16% patients in group B obtained partial responses. The response rates andMSTs were similar in groupsAandB, aswell as in more aged (≥75 years) patients. Bone marrow suppression was more frequently seen in elderly patients. Cox's hazard model in patients aged 70 years or more revealed that GEM therapy reduced the hazard ratio for death (hazard ratio: 0.683, p = 0.041). Conclusions Chemotherapy with GEM appears to be effective and safe in elderly patients as well as in younger patients. Patients with unresectable pancreatic carcinoma should receive GEM therapy even if they are aged 70 or more, even if they are aged 75 or more.

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KW - Pancreas

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