Combination Chemotherapy Prolongs 5-Year Survival Rate in Early-Stage Pancreatic Cancer After Surgery in Phase III Trial

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 was featured in a press briefing on June 3, 2016 and presented at the 2016 American Society of Clinical Oncology (ASCO) Annual Meeting (June 3-7) in Chicago, Illinois. “Unfortunately, most patients are not candidates for surgery when they are diagnosed with pancreatic cancer,” said lead study author John P. Neoptolemos, M.A., M.B., B.Chir., M.D., F.Med.Sci., the Chair of Surgery in the Department of 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.” 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. 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.
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