Chemotherapy Combinations
Gemcitabine
As mentioned early, Gemcitabine (Gemzar) is the chemotherapy of choice, for treating Pancreatic Cancer and is often used in combination with other chemotherapy drugs (depending of the diagnosis of the patient). "GEMZAR has been approved by the Food and Drug Administration (FDA) as first-line treatment for patients with locally advanced or metastatic cancer of the pancreas. Clinical studies show that GEMZAR has helped improve the survival for some patients with cancer of the pancreas; locally advanced (stage II or III) or metastatic (stage IV). To learn more about Gemcitabine click on the following link.
Tarceva
In Canada, Oncologists have also used Gemcitabine in combination with another chemotherapy drug called Tarceva, for advanced Pancreatic Cancer. To learn more about Tarceva click on the following link.
5-Fluorouracil
Lastly the combination of Gemcitabine and 5-fluorouracil (5-FU) has promising activity for advanced pancreatic cancer and biliary tract cancer, according to the results of a phase II trial published in the April 2003 issue of the American Journal of Clinical Oncology. You can click on the following link to read more about 5-Fluorouracil.
OTHER TREATMENT OPTIONS AVAILABLE IN THE UNITED STATES
Here is a general list of chemotherapy combinations. This list was taken from the John Hopkins Wesite, Discussion Board. (pathology.jhu.edu) Although many of these combinations are used by American oncologists, it is important to be informed about the various treatment options. Understanding that a variety of combinations exist for patients receiving treatment is important; if the present chemotherapy regime is not working or you feel is not aggressive enough, TALK TO YOUR ONCOLOGOST and do not hesitate to get a second opinion! OR a third opinion! OR a fourth opinion!
Typically, conservative oncologists will use gemcitabine or gemcitabine/tarceva as first-line treatments because these protocols have been approved for PC by the FDA.
More aggressive oncologists will use platinum drugs (cisplatin or oxaliplatin) in combination with gemcitabine or gemcitabine/tarceva as first-line treatments.
Some will use GTX (gemcitabine/taxotere/xeloda) as either a first-line or second-line treatment.
Other drug combinations include PEFG (cisplatin/epirubicin/5-fluorouracil/gemcitabine),
GFLIP (gemcitabine, fluorouracil leucovorin, irinotecan and cisplatin) or
FOLFOX (5-fluorouracil, oxaliplatin, leucovorin).
Progressive/aggressive oncologists will treat PC with the following chemotherapeutic drug combinations: First-line treatment: Platinum drugs (cisplatin or oxaliplatin) in combination with gemcitabine or gemcitabine/tarceva.
First or second-line treatment: GTX: gemcitabine, taxotere, xeloda
Second or third-line treatments: PEFG: cisplatin, epirubicin, 5-fluorouracil, gemcitabine
FOLFOX: 5-fluorouracil, oxaliplatin, leucovorin
GFLIP: gemcitabine, 5-FU, lLeucovorin, irinotecan, cisplatin
The list is not inclusive, since many aggressive US oncologists will use variations of the above combinations to find something that works.
Platinum drugs (cisplatin or oxaliplatin) in combination with gemcitabine or gemcitabine/tarceva. GTX: gemcitabine, taxotere, xeloda
PEFG: cisplatin, epirubicin, 5-fluorouracil, gemcitabine
FOLFOX: 5-fluorouracil, oxaliplatin, leucovorin GFLIP: gemcitabine, 5-FU, lLeucovorin, irinotecan, cisplatin ??