CIRCADIAN-RHYTHM MODULATED 5-FUDR INFUSION WITH MEGACE IN THE TREATMENT OF ADVANCED PANCREATIC-CANCER

Thirteen patients with advanced pancreatic carcinoma were treated with circadian rhythm modulated infusion of 5-FUdR and Megace. Treatment w as initiated at a dose of 0. 15 mg/kg/day for 14 days every 28 days an d was increased or decreased by 0.025 mg/kg/day with each subsequent c ycle until maximum tolerated dose (MTD) was achieved. Megace (200 mg) was administered daily in divided doses. One-third of the patients wer e able to complete greater-than-or-equal-to 6 cycles of treatment, one -half could only complete less-than-or-equal-to 2 cycles, and the rema inder managed 3-4 cycles. No patients had regression of disease, but a small number, who were able to receive 6-7 months of treatment, achie ved stable disease in the short term. In conclusion, treatment was fai rly well tolerated. However, increased dose intensity by this method d id not significantly increase response rate. In only a few patients wa s disease stabilized for a brief period. Megace did not materially imp rove nutritional status. CA-19-9 levels did not correlate well with di sease activity. (C) 1994 Wiley-Liss, Inc.