Capecitabine improves survival in pancreatic cancer
Advanced pancreatic cancer: addition of capecitabine should be considered |
Treatment regimens
Patients were assigned to one of:
· capecitabine 1,660mg/m2/day for 21 days followed by one week’s
rest plus gemcitabine 1,000mg/m2 weekly for three weeks
followed by one week’s rest
· gemcitabine 1,000mg/m2 weekly
for seven weeks, then one week’s
rest, followed by weekly for three weeks, followed by one week’s
rest |
Adding the oral chemotherapy drug capecitabine (Xeloda) to standard chemotherapy with gemcitabine (Gemzar) increases survival for patients with advanced pancreatic cancer, results from one of the largest trials in this type of cancer have shown.
The study, funded and designed by Cancer Research UK, randomised 533
previously untreated patients with locally advanced or metastatic pancreatic
cancer to capecitabine plus gemcitabine or to gemcitabine alone.
Capecitabine is a targeted, oral chemotherapy drug that is activated
to
5-fluorouracil by an enzyme that occurs at higher levels in cancer cells
than in non-cancerous tissues.
Patients on the combination therapy lived longer than those given standard
chemotherapy (median survival 7.4 months versus 6.0 months; hazard ratio
0.80) — 26 per cent were alive at one year, compared with 19 per
cent of the standard treatment group.
Reporting the findings, David Cunningham, Royal Marsden Hospital, Sutton,
said: “These findings are exciting and give new hope for patients
with advanced pancreatic cancer, who generally have very short life-expectancy.” He
suggested that the combination of gemcitabine plus capecitabine should
now be considered one of the standard treatment options for advanced
pancreatic cancer.
Steve Williamson, lead pharmacist for cancer services, Northumbria Healthcare
NHS Trust, and a member of the Cancer Network Pharmacists Forum, commented: “This
is a straightforward regimen to administer that has been well tolerated
by patients in the trial within our cancer network. While the survival
benefit shown is small, it is significant for this group of patients.” He
added: “The cost-effectiveness of adding capecitabine to gemcitabine
must now be considered.” The results were presented at the European
Cancer Conference (ECCO), held in Paris from 30 October to 3 November. |
The
Pharmaceutical Journal
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