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A small trial that made gemcitabine the standard chemotherapy for pancreatic cancer for the next fifteen years, on the strength of more patients feeling better on treatment and a modest gain in survival over fluorouracil.
Burris and colleagues randomised 126 patients with advanced, symptomatic pancreatic cancer to weekly gemcitabine or weekly bolus fluorouracil. The primary endpoint was clinical benefit response, a composite of pain, performance status and weight, which gemcitabine improved in about a quarter of patients compared with a few percent on fluorouracil. Median survival was modestly longer and more patients were alive at one year. The trial led to gemcitabine's approval and defined the comparator arm for every pancreatic cancer trial until FOLFIRINOX and nab-paclitaxel.
This trial introduced a patient-centred composite endpoint and a drug that remained the backbone of pancreatic cancer treatment for a generation. Its small survival gain also shows how low the bar was, which is the context for the FOLFIRINOX and MPACT trials that followed.
Shares Fluorouracil (5-FU), Gemcitabine, Metastatic pancreatic ductal adenocarcinoma, Pancreatic ductal adenocarcinoma.
Shares Resectable pancreatic ductal adenocarcinoma, Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question, Fluorouracil (5-FU), Gemcitabine.
Shares Conroy 2011: FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer (PRODIGE 4/ACCORD 11), Overall survival (OS), Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question, Fluorouracil (5-FU).
Shares Quality of life, Fluorouracil (5-FU), Gemcitabine, Metastatic pancreatic ductal adenocarcinoma.
Shares MPACT (Von Hoff 2013): nab-paclitaxel plus gemcitabine for metastatic pancreatic cancer, Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question, Metastatic pancreatic ductal adenocarcinoma, Pancreatic ductal adenocarcinoma.
Shares Resectable pancreatic ductal adenocarcinoma, Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question, Gemcitabine, Pancreatic ductal adenocarcinoma.
Shares Resectable pancreatic ductal adenocarcinoma, Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question, Metastatic pancreatic ductal adenocarcinoma, Pancreatic ductal adenocarcinoma.
Shares Overall survival (OS), Gemcitabine, Metastatic pancreatic ductal adenocarcinoma, Pancreatic ductal adenocarcinoma.