Background : No single agent or combination therapy for advanced pancreatic cancer has been reported superior to single-agent GEM, and an effective second-line chemotherapy option is needed for patients who are resistant to first-line GEM therapy.
Methods : We analyzed six patients who had disease progression following first-line gemcitabine therapy. Patients received second-line chemotherapy with low dose cisplatin, 5-fluorouracul or S-1, and gemcitabine every 21 days.
Results : Two patients showed a partial response (33.3%) and two showed stable disease. Four patients (66.6%) showed a prolonged survival time with partial responses or stable disease. Median survival times were 7 and 11 months from the start of second-line therapy and the start of first-line gemcitabine therapy, respectively. In addition, all patients reported relief from pain and had a favorable performance status. The major toxicities of leucopenia, stomatitis, and diarrhea were found in one patient each.
Conclusion : This second-line chemotherapy regimen is an effective option for patients with gemcitabineresistant pancreatic cancer.

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