Abstract
Gastrin has been shown to be a growth stimulant in pancreatic cancer cells. Gastrazole is a potent and selective gastrin receptor antagonist. Two randomised blinded trials were conducted to assess the effect of gastrazole in advanced pancreatic cancer. Patients with biopsy-proven, inoperable pancreatic carcinoma were recruited. Trial A compared protracted venous infusion (PVI) gastrazole with PVI placebo, whereas trial B compared PVI gastrazole with PVI fluorouracil (5-FU). Eighteen patients were randomised in trial A. Gastrazole produced significantly better survival compared to placebo (median 7.9 months vs 4.5 months; 1-year survival: 33 vs 11%, respectively; log rank P=0.02). No difference in toxicity was seen between gastrazole and placebo, except central venous catheter and pump complications. Ninety-eight patients were randomised in trial B. No significant survival difference was detected between gastrazole and 5-FU (median: 3.6 vs 4.2 months; 1-year survival: 13.2 vs 26.2%, respectively; log rank P=0.42). Toxicity of gastrazole was mild with significantly less diarrhoea (P=0.03), stomatitis (P<0.001) and hand- foot syndrome (P<0.001) compared to 5-FU. Quality of life (QoL) assessment showed similar QoL between gastrazole and 5-FU at baseline and no significant differences occurred with treatment either between arms or within arms. Compared to placebo, patients with advanced pancreatic cancer treated with gastrazole appeared to live longer, albeit in a very small trial and will require confirmation with large-scale randomised data. However, it did not produce survival advantage over PVI 5-FU. Lack of toxicity for gastrazole may allow its combination with cytotoxic drugs.
Original language | English |
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Pages (from-to) | 1107-15 |
Number of pages | 9 |
Journal | British Journal of Cancer |
Volume | 94 |
Issue number | 8 |
DOIs | |
Publication status | Published - 24 Apr 2006 |
Keywords
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Agents
- Disease Progression
- Dose-Response Relationship, Drug
- Double-Blind Method
- Female
- Fluorouracil
- Follow-Up Studies
- Humans
- Infusions, Intravenous
- Male
- Middle Aged
- Pancreatic Neoplasms
- Pilot Projects
- Placebos
- Predictive Value of Tests
- Receptor, Cholecystokinin B
- Single-Blind Method
- Survival Rate
- Time Factors
- Treatment Outcome