Gemcitabine Combined with Capecitabine Compared to Gemcitabine with or without Erlotinib as First-Line Chemotherapy in Patients with Advanced Pancreatic Cancer
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Purpose The purpose of this study is to retrospectively compare the efficacy and tolerability betweenthree regimens for first-line chemotherapy—gemcitabine plus capecitabine (GEM-X),gemcitabine plus erlotinib (GEM-T), and gemcitabine monotherapy (GEM)—in patients withadvanced pancreatic cancer. Materials and MethodsThere was a total of 127 patients who underwent chemotherapy for pancreatic cancerbetween January 2007 and November 2011 at our institution. Patients were treated witheither GEM (gemcitabine 1,000 mg/m2 on days 1, 8, and 15 every 4 weeks), GEM-T(gemcitabine 1,000 mg/m2 on days 1 and 8 every 3 weeks and erlotinib 100 mg daily), orGEM-X (gemcitabine 1,000 mg/m2 on days 1 and 8 every 3 weeks and capecitabine 850mg/m2 twice daily for 2 weeks followed by 1 week’s rest) as the first-line treatment. Progression-free survival (PFS), overall survival (OS), objective response rate (ORR), and toxicitywere evaluated. ResultsThe patient population was divided into groups depending on their first-line treatment: GEM(n=47), GEM-T (n=44), and GEM-X (n=36). GEM-X significantly improved ORR (21.2% vs. 12.7% and 15.9%), PFS (8.9 vs. 5.2 and 3.9 months; p < 0.001), and OS (12.1 vs. 10.4and 9.9 months; p = 0.03) compared to GEM and GEM-T, respectively. There were higherincidences of some non-hematologic adverse events with GEM-X and GEM-T compared toGEM, but most were grade 1 or 2. ConclusionGEM-X presented better clinical efficacy and acceptable tolerability than GEM-T and GEMin advanced pancreatic cancers. It is worthy to further investigate which agent has a clinicaladvantage as a combination drug with gemcitabine in pancreatic cancer and to explore thepredictive markers leading to personalize anti-cancer treatment.
Abstract
Purpose The purpose of this study is to retrospectively compare the efficacy and tolerability betweenthree regimens for first-line chemotherapy—gemcitabine plus capecitabine (GEM-X),gemcitabine plus erlotinib (GEM-T), and gemcitabine monotherapy (GEM)—in patients withadvanced pancreatic cancer. Materials and MethodsThere was a total of 127 patients who underwent chemotherapy for pancreatic cancerbetween January 2007 and November 2011 at our institution. Patients were treated witheither GEM (gemcitabine 1,000 mg/m2 on days 1, 8, and 15 every 4 weeks), GEM-T(gemcitabine 1,000 mg/m2 on days 1 and 8 every 3 weeks and erlotinib 100 mg daily), orGEM-X (gemcitabine 1,000 mg/m2 on days 1 and 8 every 3 weeks and capecitabine 850mg/m2 twice daily for 2 weeks followed by 1 week’s rest) as the first-line treatment. Progression-free survival (PFS), overall survival (OS), objective response rate (ORR), and toxicitywere evaluated. ResultsThe patient population was divided into groups depending on their first-line treatment: GEM(n=47), GEM-T (n=44), and GEM-X (n=36). GEM-X significantly improved ORR (21.2% vs. 12.7% and 15.9%), PFS (8.9 vs. 5.2 and 3.9 months; p < 0.001), and OS (12.1 vs. 10.4and 9.9 months; p = 0.03) compared to GEM and GEM-T, respectively. There were higherincidences of some non-hematologic adverse events with GEM-X and GEM-T compared toGEM, but most were grade 1 or 2. ConclusionGEM-X presented better clinical efficacy and acceptable tolerability than GEM-T and GEMin advanced pancreatic cancers. It is worthy to further investigate which agent has a clinicaladvantage as a combination drug with gemcitabine in pancreatic cancer and to explore thepredictive markers leading to personalize anti-cancer treatment.
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