The role of gemcitabine alone and in combination in the treatment of pancreatic cancer

Pancreatic cancer, one of the most frequently reported gastrointestinal tum ors, has a 5-year survival of less than 5%. Despite representing only 2-3% of the total cancer incidence, it is the fifth leading cause of cancer deat h. This is because it is commonly only diagnosed at an advanced stage. Unti l recently the traditional therapy for patients with advanced disease was p alliative ti-fluorouracil (5-FU)-based chemotherapy. However, the novel ant inucleoside gemcitabine (Gemzar(R)) has demonstrated a survival benefit ove r 5-FU, and an improvement in disease-related symptoms and quality of life in patients with advanced disease. This review presents an overview of the clinical studies of gemcitabine, either alone or in combination, with other chemotherapeutic: agents and/or radiation therapy, in the treatment of the se patients. A comparison of these studies; is made with those using altern ative treatment regimens. The data suggest that gemcitabine in combination with biomodulated 5-FU should be considered the standard palliative treatme nt to which other new drug combinations or combined modality chemoradiation regimens should be compared. [(C) 2000 Lippincott Williams & Wilkins.].