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GemOx (gemcitabine 1000 mg/m(2)100 min on day 1 and oxaliplatin 100 mg/m(2) on day 2 every 2 weeks) achieved a response rate of 26.8%, improved progression-free survival (PFS) but failed to demonstrate a benefit in overall survival (OS) compared with gemcitabine in pancreatic cancer. This regimen has regained attention after recent pooled- and meta-analysis suggested a survival benefit of gemcitabine-platinum doublets over gemcitabine. However, GemOx is associated with inconvenience to patients, early cumulative dose developing neuropathy and thrombocytopenia. In addition, fixed dose rate of gemcitabine showed no benefit30 min infusion schedule in the ECOG6201 study. Pharmacokinetic profiles of both drugs did not show statistically significant difference regardless of the order of administration.In order to create a more convenient and equally effective regimen, we conducted a retrospective study to evaluate the efficacy and safety of single-day modified GemOx (S-GemOx, gemcitabine 1000 mg/m(2)30 min and oxaliplatin 85 mg/m(2)2 h on day 1 every 2 weeks) in patients with pancreatic and biliary cancers.In all, 34 patients (median age 60 years, male/female: 17/17) received S-GemOx including locally advanced or metastatic pancreatic cancer (26) and biliary duct carcinoma (8). Median treatment was six cycles with duration of 12 weeks (range (r): 2 - 56). Median cumulative dose of oxaliplatin was 517.5 mg/m(2) (r: 85 - 2380). A total of 27 of 34 patients were evaluated for efficacy after initial staging: 1 (3.7%) complete response (CR), 4 (14.8%) partial response (PR), 18 (66.7%) stable disease and 4 (14.8%) progression of disease. Overall response rate (CR + PR) was 18.5%. Median PFS and OS were 7 and 11.6 months, respectively. All patients were assessed for toxicities. Grade 3/4 hematological toxicities include anemia (8%), neutropenia (11%), thrombocytopenia (5%), nausea/vomiting (3%), diarrhea (3%), hypersensitivity reaction (14%) and neuropathy (3%). No deaths occurred due to therapy.S-GemOx regimen provides convenient schedule, toxicities appear to be comparable with GemOx. The incidence of neuropathy (3 vs 19.1%) and thrombocytopenia (5 vs 14%) are substantially lower compared with GemOx. Prospective studies of S-GemOx in a large patient population are warranted.

Taxotere has recently been making a noticeable impact on breast, gastric, ovarian, prostate and non-small cell lung cancers. Its side effects include dyspnea, pruritus, skin rashes, fever and hypotension. The patient presented the less common, however potentially fatal, toxicity of pneumonitis. He initially presented with a flu-like illness and hypoxia that was unresponsive to antibiotic treatment and actually progressed. He presented 14 days after his second dose of taxotere, although in retrospect noted symptoms several days prior. Although some patients described in the literature have progressed to respiratory failure requiring mechanical ventilation, this patient responded to steroid treatment and withdrawal of taxotere.