TY  -  JOUR
AU  -  Giuliani, Jacopo
AU  -  Bonetti, Andrea
T1  -  The gemcitabine and oxaliplatin (GEMOX) for advanced pancreatic cancer: the reports of my death have been greatly exaggerated?
PY  -  2017
Y1  -  2017-12-01
DO  -  10.1701/2829.28584
JO  -  Recenti Progressi in Medicina
JA  -  Recenti Prog Med
VL  -  108
IS  -  12
SP  -  521
EP  -  527
PB  -  Il Pensiero Scientifico Editore
SN  -  2038-1840
Y2  -  2026/04/26
UR  -  http://dx.doi.org/10.1701/2829.28584
N2  -  Summary. The analysis was conducted to assess the effect of front-line combination chemotherapies on the overall survival and progression free survival (PFS) and was restricted to phase III randomized controlled trials (RCTs) in first-line therapy for advanced pancreatic cancer. We have subsequently applied the European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS) to the above phase III RCTs, to derive a relative ranking of the magnitude of clinically meaningful benefit. We have also calculated differences in PFS between the different arms of each trial and the pharmacological costs necessary to get the benefit in PFS, for each trial. Our study evaluated 11 phase III RCTs, including 4572 patients. Combining the costs of therapy with the measure of efficacy represented by the PFS, we have obtained 74.12 € per month of PFS gained for 5-FU, leucovorin, irinotecan and oxaliplatin (FOLFIRINOX), 90.14 € per month of PFS gained for gemcitabine and oxaliplatin (GEMOX) and 4708.70 € per month of PFS gained for the combination of gemcitabine plus nab-paclitaxel against gemcitabine alone. From this perspective, we believe that “old combination chemotherapies” (eg., GEMOX) should not be completely abandoned, but reasoned on the individual patient, based on different factors (age, ECOG PS, comorbidity, disease burden) in order to achieve a real tailored therapy.
ER  -