The doxorubicin-streptozotocin combination for the treatment of advanced well-differentiated pancreatic endocrine carcinoma: A judicious option?

Th Delaunoit, M. Ducreux, V. Boige, C. Dromain, J. C. Sabourin, P. Duvillard, M. Schlumberger, T. De Baere, P. Rougier, P. Ruffie, D. Elias, P. Lasser, E. Baudin

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    Résumé

    Due to their rarity, only few trials have studied the role of the doxorubicin-streptozotocin (DS) combination in advanced well-differentiated pancreatic endocrine carcinomas (AWDPEC). However, the published results are inconsistent. We reviewed all AWDPEC (5-year period, 45 patients) treated in our institution with the DS combination for: objective response rate (ORR), progression-free survival, overall survival (OS) and toxicity. An ORR of 36% (95% Confidence Interval (CI) 22-49) was obtained, with 16 partial responses (PR). The mean duration of PR was of 19.7 months. Two and 3-year OS rates were 50.2 and 24.4%, respectively. Toxicities were mainly digestive (grade ≥3 vomiting, 13%) and haematological (grade ≥3 neutropenia, 24%). Previous systemic chemotherapy and malignant hepatomegaly were associated with a poorer ORR (P=0.033, P=0.016) and OS (P=0.008, P=0.045). Multivariate analysis demonstrated previous chemotherapy as the only independent predictive-factor for survival (P=0.013). In conclusion, our data confirm the sensitivity of AWDPEC to the DS combination, with an ORR of 36% and a remarkable median response duration of 19.7 months, and suggests that it could be considered as a valid option in first-line therapy.

    langue originaleAnglais
    Pages (de - à)515-520
    Nombre de pages6
    journalEuropean Journal of Cancer
    Volume40
    Numéro de publication4
    Les DOIs
    étatPublié - 1 janv. 2004

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