- (2010) Volume 11, Issue 3
Ioannis Gounaris, Kamarul Zaki, Pippa Corrie
Oncology Centre, Cambridge University Hospitals NHS Trust. Cambridge, United Kingdom
Received: 29 March 2010
Drug Therapy; gemcitabine; Neoplasm Metastasis; Pancreatic Neoplasms
Dear Sir,
We read with interest the Professor Saif’s comments regarding our recent review of treatment options after progression on gemcitabine-based regimens in patients with metastatic pancreatic cancer [1]. We agree that innovative trial designs, testing agents based on sound preclinical evidence and with correlative biomarker studies are sorely needed if we are to improve outcomes. In this setting, randomised “pick the winner” phase II trials may be a reasonable way forward. If participation in a clinical trial is impossible, his proposed algorithm for treatment selection is a useful starting point, although it is to be expected that reasonable clinicians will disagree regarding the relative importance and priority of specific agents as high level evidence is lacking. However, we emphasize that our opinion is that for every patient with gemcitabine-resistant pancreatic cancer in whom further treatment is appropriate, participation in a clinical trial should be the first option.
The authors have no potential conflicts of interest
