BACKGROUND: Gemcitabine- and 5-fluorouracil (5-FU)- based chemotherapy is a 
commonly used adjuvant or palliative treatment for patients with pancreatic 
cancer. However, a standard chemotherapy regimen has yet to be developed for 
patients refractory to gemcitabine and 5-FU treatment. We attempted to evaluate 
the efficacy and safety of a combination of irinotecan and oxaliplatin (IROX) as 
a salvage treatment for patients with gemcitabine- and 5-FU- refractory 
pancreatic cancer.
PATIENTS AND METHODS: Patients with advanced pancreatic cancer who were 
refractory to prior gemcitabine- and 5-FU- based chemotherapy were enrolled in 
this study. IROX chemotherapy was administered as follows: Irinotecan, 150 
mg/m(2) on day 1; and oxaliplatin, 85 mg/m(2) on day 1 over 90 min every 2 
weeks.
RESULT: From Mar. 2006 to Dec. 2008, a total of 14 patients were administered 50 
cycles of chemotherapy. The male-to-female ratio of the patient group was 11:3. 
These patients ranged in age from 48 to 73 years (median 65.5 years old). 3 
patients (21.4%) evidenced partial responses. four patients (28.6%) exhibited 
stable disease. The median time to progression and overall survival time were 
1.4 (95% CI: 1.2-1.6) months and 4.1 (95% CI: 2.0-6.2) months, respectively. 
Major hematologic toxicities included grade 1-2 anemia (88%), neutropenia (36%), 
thrombocytopenia (30%), and grade 3-4 neutropenia (10%). The most frequently 
detected non-hematological toxicities were grade 3 diarrheas (14%).
CONCLUSION: The IROX regimen appears to constitute a feasible and tolerable 
salvage therapy in patients with advanced pancreatic cancer who have been 
previously treated with gemcitabine- and 5-FU-based chemotherapy.