SAN FRANCISCO—In patients with advanced pancreatic cancer, the
combination of gemcitabine (Gemzar) followed by oxaliplatin (investigational in
the United States) (GEMOX) is active with low toxicity, Christophe Louvet, MD,
Hôpital St-Antoine, Paris, France, said at the 37th Annual Meeting of the
American Society of Clinical Oncology (ASCO abstract 506).

The rationale for the gemcitabine/oxaliplatin combination is that the two
agents have distinctly different mechanisms of action and patterns of
resistance without overlapping toxicities.

Preclinical investigations looking into the possible combined effects of
gemcitabine/oxaliplatin or gemcitabine/cisplatin (Platinol) found the best
synergy effects for the sequence of gemcitabine followed by oxaliplatin, Dr.
Louvet said.

The current phase II trial included 64 patients (mean age, 59.5 years)
treated at eight centers; 47% had stage II-III locally advanced disease and 53%
had stage IV metastatic disease. Enrollment criteria included Karnofsky
performance status of 60 to 100.

The Regimen

Patients received gemcitabine 1,000 mg/m² in a 10 mg/m²/min infusion on
day 1 and oxaliplatin 100 mg/m² in a 2-hour infusion on day 2. Treatment was
repeated every 2 weeks for six cycles followed by chemoradiation with
fluorouracil in locally advanced patients, or until progression of disease in
metastatic patients.

Partial responses were reported in 19 patients, stable disease in 28, and
progressive disease in 16, for a response rate of 30.2%. Response rates for
locally advanced patients (31%) and metastatic disease patients (30.3%) were
similar. The clinical benefit response rate was 39.7% (23 of 58 patients), Dr.
Louvet said.