Low-dose continuous infusion 5-fluorouracil combined with weekly leucovorin, nab-paclitaxel, oxaliplatin, and bevacizumab for patients with advanced pancreatic cancer: A pilot study.

e14545 Background: Gemcitabine based chemotherapy has become the standard of care for first-line treatment of patients with advanced pancreatic cancer. However, median survival remains disappointing. Continuous infusion 5-fluorouracil (5 FU), calcium leucovorin plus paclitaxel and oxaliplatin has shown activity in patients with pancreatic cancer. As a protracted low dose infusion, 5FU is antiangiogenic and potentiates bevacizumab as observed in the treatment of colon cancer. When combined with bevacizumab, nab-paclitaxel is also synergetic because of its antiangiogenic properties. We administered low doses of continuous cytotoxic chemotherapy with conventional anti-VEGF therapy for patients with advanced pancreatic cancer. Methods: Since July of 2008 we treated 28 patients with 5 FU (180 mg/m2/d) as a continuous infusion on days 1-15 via ambulatory chemotherapy pump into a surgically placed central venous line. Calcium leucovorin (20 mg/m2) IVP, nab-paclitaxel (100 mg/m2) IV as a 30 minute infusion and ox...