Combination gemcitabine and docetaxel therapy in advanced adenocarcinoma of the pancreas

Objective: To determine the clinical and laboratory response rate of a gemc itabine and docetaxel combination in human adenocarcinoma of the pancreas i n vitro and in vivo. Methods: Fifteen patients with unresectable pancreatic cancer were treated with gemcitabine, 900 mg/m(2), and docetaxel, 90 mg/m( 2), every 3 weeks. Two human pancreatic cancer lines were tested in MTT ass ays for their response to titrations of gemcitabine and/or docetaxel at dif ferent time points and scheduling for biochemical synergy or additional ant itumor effects. Results: In vitro testing showed that these two agents were minimally effective alone but when combined, they displayed additional bio chemical antiproliferative effects in MTT assays. With intent-to-treat anal ysis of all 15 patients, 4 patients (27%) achieved an objective response by CT scan, including one complete response. Seven patients (47%) had subject ive improvement and decreased serum marker levels of CA 19-9. None of the 1 2 patients without prior therapy developed nadir white blood cell counts be low 1,000/mm(3); 2 of 3 patients with prior radiation therapy developed nad ir white blood cell counts below 1,000/mm3. Conclusion: This regimen is wel l tolerated and appears to have a significant objective response rate. Gemc itabine and docetaxel antitumor effects are additive in vitro, which may he lp to explain the response rate. Copyright (C) 2001 S. Karger AG, Basel.