Pancreatic cancer remains a chemo-resistant disease (1). Gemcitabine has been an acceptable standard for more than a decade. The benefit of single-agent gemcitabine in advanced pancreatic cancer (APC) is small (2). Adding other chemotherapy agents to gemcitabine did not result in meaningful improvement in survival (3). The randomized trials studying the addition of molecular targeting agents to gemcitabine vs. gemcitabine alone have also been disappointing (4). A small gain in median survival by adding erlotinib to gemcitabine has recently been reported (5).
Taxanes, paclitaxel and docetaxel, have also been studied in the treatment of APC. Taxanes have demonstrated some activity in preclinical pancreatic cancer models (6, 7). In 3 clinical trials docetaxel had an objective RR of 0–15% (8–10) and in 3 clinical trials paclitaxel had an objective RR of 0–8% (11–13). Median OS in trials of the two drugs ranged from 4 to 8 months. One patient with prior gemcitabine treatment had a complete response (CR) after treatment with paclitaxel (13).