Adding capecitabine to gemcitabine chemotherapy prolongs survival after pancreatic cancer surgery

According to a study published in January 2017 in the respected medical journal Lancet, to reduce recurrence risk after pancreatic cancer surgery, adjuvant treatment with gemcitabine chemotherapy, with the addition of capecitabine , a chemotherapy medicine taken orally as a pill, significantly prolonged survival.

Pancreatic cancer is not among the most common cancers, but ranks 4th in cancer-related deaths in both women and men in the United States; worldwide, among men it causes 138 thousand deaths annually and ranks 8th, while among women it causes 127 thousand annually and ranks 9th.

This disease is very rare before age 45. Identified risk factors include smoking, obesity, physical inactivity, chronic pancreatitis, hereditary factors and diabetes.

This disease usually causes no symptoms in its early stages, and only about %10 of patients are diagnosed early, with localized disease suitable for surgery. If the tumor can be removed, surgery should be performed, as it is the only chance of curing the disease. Even if the entire tumor is surgically removed, pancreatic cancer has a high recurrence risk. Previous studies showed that postoperative adjuvant chemotherapy reduced patients’ survival time and recurrence risk, and gemcitabine chemotherapy became the standard adjuvant approach for early-stage pancreatic cancer.

Study

The study included patients whose tumors had been completely removed surgically: 732 patients with pancreatic cancer. For adjuvant treatment, patients were divided into 2 groups. One received weekly gemcitabine and capecitabine over 12 weeks, with 3 weeks of treatment followed by 1 week off; the other received gemcitabine alone.

Capecitabine combined with gemcitabine reduced the risk of death by %18 compared with gemcitabine alone.

Median overall survival was 28 months in the combination group versus 25.5 months among those receiving gemcitabine alone.

In conclusion, this adjuvant combination should be considered a new treatment standard for patients who have undergone surgery for pancreatic cancer.