Photo by Phil and Pam

Chemotherapy Combination With Capecitabine Extends Survival After Pancreatic Cancer Surgery

Article
Digestive Health
Laboratory Procedures
+3
Contributed byMaulik P. Purohit MD MPHJun 05, 2016

CHICAGO – A European phase III trial, one of the largest ever conducted in pancreatic cancer, showed that adding the oral drug capecitabine chemotherapy to gemcitabine prolongs survival without increased toxicity. Adjuvant gemcitabine chemotherapy is currently the standard of care worldwide after surgical removal of pancreatic cancer.

The study will be featured in a press briefing today and presented at the 2016 American Society of Clinical Oncology (ASCO) Annual Meeting.

“Unfortunately, most patients are not candidates for surgery when they are diagnosed with pancreatic cancer,” said lead study author John P. Neoptolemos, MA, MB, BChir, MD, FMedSci, the chair of surgery in the Department Molecular and Clinical Cancer Medicine at the University of Liverpool in Liverpool, United Kingdom. “These findings are significant because they show that those patients who can undergo surgery have a fighting chance of surviving this cancer with the combination of two commonly used chemotherapies.”

The Study

With 732 patients, the European Study Group for Pancreatic Cancer (ESPAC) 4 trial is the second-­largest clinical trial ever conducted in patients with pancreatic cancer who had undergone surgery. Within 12 weeks of surgery, patients with early-­‐stage pancreatic ductal adenocarcinoma were randomly assigned to receive either gemcitabine alone or gemcitabine with capecitabine for 24 weeks.

Key Findings

The median overall survival was 28.0 months with the combination regimen vs. 25.5 months with gemcitabine alone. The estimated 5-­‐year survival rates were 28.8% vs. 16.3% in the two groups. “The difference in median survival may seem modest, but the improvement in long-­‐term survival is substantial for this cancer,” said Dr. Neoptolemos. “We’ve gone from a five-­‐year survival rate of 8% with surgery alone to nearly 30% with adjuvant therapy.”

According to the authors, the patient characteristics were representative of a real-­‐world pancreatic cancer population. A large proportion of patients had unfavorable prognostic factors, such as locally advanced or aggressive disease, large tumor size, or incomplete removal of the tumor.

The survival advantage with the combination regimen was similar irrespective of such factors. Patients who had been smokers but stopped smoking after their diagnosis had better outcomes than those who continued smoking.

Overall, there were no major differences in the types and severity of side effects between the two groups. Severe diarrhea was slightly more common with the combination regimen (14 vs. 5 patients), as was fatigue (16 vs. 14 patients). Quality of life was also comparable between the two groups.

Next Steps

The safety of this new gemcitabine-­‐capecitabine chemotherapy regimen opens the opportunity to add other treatments to this combination, which might further improve outcomes for patients. Future research efforts will focus on   developing tests to predict which patients would benefit most from a particular adjuvant therapy.

About Gemcitabine and Capecitabine

Gemcitabine is an intravenous chemotherapy used as a standard adjuvant treatment for early pancreatic cancer. In the United States, gemcitabine is also approved to treat patients with breast, ovarian and lung cancer. Capecitabine is an oral chemotherapy drug approved in the United States for treatment of patients with breast and colorectal cancers. Gemicitabine and capecitabine are both available as generic drugs.

About Pancreatic Cancer

In 2012, 338,000 people were diagnosed with pancreatic cancer worldwide.1 The highest incidence of pancreatic cancer was in North America and Europe, and the lowest incidence in Africa and Asia. In 2016, an estimated 53,070 adults in the United States will be diagnosed with pancreatic cancer.2 Pancreatic cancer is the fourth leading cause of cancer death in the United States. It is estimated that 41,780 deaths from this disease will occur this year.

This study received funding from Cancer Research UK.

View the full abstract. 


The above post is reprinted from materials provided by American Society of Clinical Oncology (ASCO)Note: Materials may be edited for content and length.

Disclaimer: DoveMed is not responsible for the adapted accuracy of news releases posted to DoveMed by contributing universities and institutions.

Was this article helpful

On the Article

Maulik P. Purohit MD MPH picture
Approved by

Maulik P. Purohit MD MPH

Assistant Medical Director, Medical Editorial Board, DoveMed Team

0 Comments

Please log in to post a comment.

Related Articles

Test Your Knowledge

Asked by users

Related Centers

Loading

Related Specialties

Loading card

Related Physicians

Related Procedures

Related Resources

Join DoveHubs

and connect with fellow professionals

Related Directories

Who we are

At DoveMed, our utmost priority is your well-being. We are an online medical resource dedicated to providing you with accurate and up-to-date information on a wide range of medical topics. But we're more than just an information hub - we genuinely care about your health journey. That's why we offer a variety of products tailored for both healthcare consumers and professionals, because we believe in empowering everyone involved in the care process.
Our mission is to create a user-friendly healthcare technology portal that helps you make better decisions about your overall health and well-being. We understand that navigating the complexities of healthcare can be overwhelming, so we strive to be a reliable and compassionate companion on your path to wellness.
As an impartial and trusted online resource, we connect healthcare seekers, physicians, and hospitals in a marketplace that promotes a higher quality, easy-to-use healthcare experience. You can trust that our content is unbiased and impartial, as it is trusted by physicians, researchers, and university professors around the globe. Importantly, we are not influenced or owned by any pharmaceutical, medical, or media companies. At DoveMed, we are a group of passionate individuals who deeply care about improving health and wellness for people everywhere. Your well-being is at the heart of everything we do.

© 2023 DoveMed. All rights reserved. It is not the intention of DoveMed to provide specific medical advice. DoveMed urges its users to consult a qualified healthcare professional for diagnosis and answers to their personal medical questions. Always call 911 (or your local emergency number) if you have a medical emergency!