Palliative meflep therapy in advanced pancreatic cancer: Excellent response in a patient with her-2/neu amplification

Yee Chao, Jacqueline Ming Liu, Anna Fen YauLi, Ching Lin Perng, Chue Mei Tiu, Kuan Liang King, Li Tzong Chen, Wei Chun Lin, Chieh Lan, Jacqueline Whang-Peng

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Introduction Patients with pancreatic cancer often present initially in advanced disease with many compromising factors, and yet they may still be responsive to chemotherapy. Aims The response of 23 patients with advanced pancreatic cancer to continuous infusion therapy was investigated. Methodology From September 1995 to February 1998, 23 patients with advanced pancreatic cancer, many with compromising factors, were treated with a MEFLEP regimen: biweekly 24-hour infusions of etoposide, 5-fluorouracil, leucovorin, epirubicin, and cisplatin, all given through an infusion pump, plus megestrol acetate, 160 mg/d, taken daily. A total of 145 courses were given. Overall response rate was 21% (4/19) for assessable chemo-naive patients; median survival for all 23 patients was 6 months; 22% of patients were alive at 1 year; and a clinical response benefit was attained in 35%. Results Toxicity was manageable; grade 3 or 4 leukopenia occurred in 1 patient each, 1 patient had fever and grade 3 infection, and grade 3 and 4 hyperammonemic encephalopathy developed in 3 and 1 patients, respectively. All four of the latter patients recovered uneventfully within 2 days of initiation of therapy. Nine patients were evaluated by fluorescence in situ hybridization for the Her-2/ neu oncogene, but for only one patient did amplification of the gene occur. She attained complete remission with treatment and lived for 26.7 months after diagnosis. Conclusion Biweekly MEFLEP is an active and manageable regimen for patients with advanced pancreatic cancer with compromised clinical status.

Original languageEnglish
JournalNursing
Volume25
Issue number1
Publication statusPublished - Jan 1 2002
Externally publishedYes

Fingerprint

Pancreatic Neoplasms
Palliative Care
Megestrol Acetate
Infusion Pumps
Epirubicin
Leucovorin
Gene Amplification
Leukopenia
Brain Diseases
Etoposide
Fluorescence In Situ Hybridization
Oncogenes
Fluorouracil
Cisplatin
Fever
Therapeutics

Keywords

  • Continuous infusion chemotherapy
  • Megestrol acetate
  • Pancreatic cancer
  • Poor performance status

ASJC Scopus subject areas

  • Emergency
  • Critical Care
  • Assessment and Diagnosis
  • Advanced and Specialised Nursing
  • LPN and LVN

Cite this

Palliative meflep therapy in advanced pancreatic cancer : Excellent response in a patient with her-2/neu amplification. / Chao, Yee; Liu, Jacqueline Ming; YauLi, Anna Fen; Perng, Ching Lin; Tiu, Chue Mei; King, Kuan Liang; Chen, Li Tzong; Lin, Wei Chun; Lan, Chieh; Whang-Peng, Jacqueline.

In: Nursing, Vol. 25, No. 1, 01.01.2002.

Research output: Contribution to journalArticle

Chao, Y, Liu, JM, YauLi, AF, Perng, CL, Tiu, CM, King, KL, Chen, LT, Lin, WC, Lan, C & Whang-Peng, J 2002, 'Palliative meflep therapy in advanced pancreatic cancer: Excellent response in a patient with her-2/neu amplification', Nursing, vol. 25, no. 1.
Chao, Yee ; Liu, Jacqueline Ming ; YauLi, Anna Fen ; Perng, Ching Lin ; Tiu, Chue Mei ; King, Kuan Liang ; Chen, Li Tzong ; Lin, Wei Chun ; Lan, Chieh ; Whang-Peng, Jacqueline. / Palliative meflep therapy in advanced pancreatic cancer : Excellent response in a patient with her-2/neu amplification. In: Nursing. 2002 ; Vol. 25, No. 1.
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T2 - Excellent response in a patient with her-2/neu amplification

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AU - Liu, Jacqueline Ming

AU - YauLi, Anna Fen

AU - Perng, Ching Lin

AU - Tiu, Chue Mei

AU - King, Kuan Liang

AU - Chen, Li Tzong

AU - Lin, Wei Chun

AU - Lan, Chieh

AU - Whang-Peng, Jacqueline

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N2 - Introduction Patients with pancreatic cancer often present initially in advanced disease with many compromising factors, and yet they may still be responsive to chemotherapy. Aims The response of 23 patients with advanced pancreatic cancer to continuous infusion therapy was investigated. Methodology From September 1995 to February 1998, 23 patients with advanced pancreatic cancer, many with compromising factors, were treated with a MEFLEP regimen: biweekly 24-hour infusions of etoposide, 5-fluorouracil, leucovorin, epirubicin, and cisplatin, all given through an infusion pump, plus megestrol acetate, 160 mg/d, taken daily. A total of 145 courses were given. Overall response rate was 21% (4/19) for assessable chemo-naive patients; median survival for all 23 patients was 6 months; 22% of patients were alive at 1 year; and a clinical response benefit was attained in 35%. Results Toxicity was manageable; grade 3 or 4 leukopenia occurred in 1 patient each, 1 patient had fever and grade 3 infection, and grade 3 and 4 hyperammonemic encephalopathy developed in 3 and 1 patients, respectively. All four of the latter patients recovered uneventfully within 2 days of initiation of therapy. Nine patients were evaluated by fluorescence in situ hybridization for the Her-2/ neu oncogene, but for only one patient did amplification of the gene occur. She attained complete remission with treatment and lived for 26.7 months after diagnosis. Conclusion Biweekly MEFLEP is an active and manageable regimen for patients with advanced pancreatic cancer with compromised clinical status.

AB - Introduction Patients with pancreatic cancer often present initially in advanced disease with many compromising factors, and yet they may still be responsive to chemotherapy. Aims The response of 23 patients with advanced pancreatic cancer to continuous infusion therapy was investigated. Methodology From September 1995 to February 1998, 23 patients with advanced pancreatic cancer, many with compromising factors, were treated with a MEFLEP regimen: biweekly 24-hour infusions of etoposide, 5-fluorouracil, leucovorin, epirubicin, and cisplatin, all given through an infusion pump, plus megestrol acetate, 160 mg/d, taken daily. A total of 145 courses were given. Overall response rate was 21% (4/19) for assessable chemo-naive patients; median survival for all 23 patients was 6 months; 22% of patients were alive at 1 year; and a clinical response benefit was attained in 35%. Results Toxicity was manageable; grade 3 or 4 leukopenia occurred in 1 patient each, 1 patient had fever and grade 3 infection, and grade 3 and 4 hyperammonemic encephalopathy developed in 3 and 1 patients, respectively. All four of the latter patients recovered uneventfully within 2 days of initiation of therapy. Nine patients were evaluated by fluorescence in situ hybridization for the Her-2/ neu oncogene, but for only one patient did amplification of the gene occur. She attained complete remission with treatment and lived for 26.7 months after diagnosis. Conclusion Biweekly MEFLEP is an active and manageable regimen for patients with advanced pancreatic cancer with compromised clinical status.

KW - Continuous infusion chemotherapy

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KW - Pancreatic cancer

KW - Poor performance status

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