Low-dose sequential multi-drug regimens for advanced pancreatic cancer.

15568 Background: GFLIP is based on ex vivo sensitivity tests performed on a series of de novo human pancreas ca.The assays found many drug interactions occuring optimally at low drug concentrations.This regimen provides conditions for 4-8 drug interactions to be applied simultaneously.These interactions can reverse the individual tumors heterogeneous resistance to single drugs and combinations.,Unresectable, metastatic and recurrent pancreas ca pts were treated with a low dose q2wk version of GFLIP using Cisplatin (P) 40 mg/m, adding Docetaxel (D) 25-35 mg/m on failure of GFLIP. Pts with PS 4, atypical ca, cystic apocrine endocrine,Ro status were excluded from analyses.Prior treatment with test drugs was allowed.Cohorts of consecutively accrued pts provided 185 prospectively registered pts for intent to treat analyses of overall survival from first diagnoses of unresectable or metastatic ca,age, stage,prior therapy and sex as prognostic factors.Another analysis omitted all pts surviving 2 yrs or more.,Pt distribution was Stage IV 66%, Stage II-III 34%, prior therapy 30 %, age 106 over age 65, 44 over age 75,14 over age 80 and 94 male pts. Median survival was 16.4 mos (14.7- 18.1 mos). 1 yr survival 62%, 2 yr 36% and 3 yr 28%. Age >65, >75 and >80 were not adverse prognostic factors p0.69-.082. Prior treatment was not an adverse prognostic factor; Median survival was 20 mo 2 yr survival 46% and 3 yr 26%. For unresectable locally advanced pts median survival was 21 mo 2 yr 36% and 3 yr 28% Analyses found no significant differences in the distribution of pts characteristics within the subsets of pts. Analyses excluding pts surviving 2 yrs or more found a median survival of 12.5 (9.6-15.5) mos. There were no treatment related deaths nor unanticipated toxicities. Hospitalization for treatment related adverse events followed less than 1% of cycles. The limiting toxicity for GFLIP was<10% late mild-moderate neuro-toxicity and on adding D brief moderate/severe cytopenias and fatigue.,Low dose GFLIP followed by GFLIP/D is safe and offers survival benefit for the majority of pts. These findings identified numerous novel research opportunities and challenge the assumption that 'all' pts with unresectable, metastatic and recurrent pancreatic ca have a dismal prognoses. No significant financial relationships to disclose.