Florouracyl. mitomycin. streptozotocin for pancreatic cancer – pro

Lay Summary: Florouracyl. mitomycin. streptozotocin for pancreatic cancer is a somewhat active older regimen that fell out of favor but deserves another look.

Aan older regimen of IV 5FU, leukovorin, mitomycin, streprozocin has been well studied in pancreatic cancer. One prospective randomized trial published in 2006 compared streptozotocin, mitomycin C, and 5-FU (SMF) with mitomycin C and 5-FU (MF) in patients with advanced pancreatic cancer. In patients with measurable disease the response rates were 34% (19/56) to SMF, and 8% (5/60) to MF (P = 0.009). Median survivals were similar, however, 18 versus 17 weeks (P = 0.356). Median survival of patients responding to chemotherapy was 33 weeks, and for nonresponders it was 17 weeks (P = 0.002). In patients with nonmeasurable disease, median survivals were 21 weeks (SMF) and 18 weeks (MF) (P = 0.797). Patients surviving 48 weeks, however, appeared to be increased in the SMF arm (14 patients) compared to the MF (7 patients). Toxicity was moderate for both regimens, with SMF having greater gastrointestinal and renal toxicity. Chemotherapy with SMF appears to produce objective responses in patients with pancreatic cancer, but does not improve survival compared to MF.

The regimen had been compared to others in older trials. Generally it was found to be comparable to other combination chemo regimens in terms of response but not superior in survival.

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