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After surgery for pancreatic cancer, six months of gemcitabine gave the same survival as fluorouracil with folinic acid, about 23 months, with half as many serious side effects.
Phase 3 trial at 159 centres in Europe, Australasia, Japan and Canada: 1,088 patients with resected pancreatic ductal adenocarcinoma were randomised to six months of fluorouracil plus folinic acid (551) or gemcitabine (537). The primary endpoint was overall survival.
After a median follow-up of 34.2 months and 753 deaths, median survival was 23.0 months with fluorouracil and 23.6 months with gemcitabine (hazard ratio 0.94, p 0.39); progression-free survival and quality of life did not differ. Treatment-related serious adverse events occurred in 14 percent of fluorouracil patients and 7.5 percent of gemcitabine patients.
Either regimen was acceptable adjuvant therapy in 2010, with gemcitabine preferred for tolerability; combination regimens (ESPAC-4, PRODIGE 24) have since superseded both.
Shares A randomized trial of chemoradiotherapy and chemotherapy after resection of pancreatic cancer, JAMA, Resectable pancreatic ductal adenocarcinoma, Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question.
Shares JAMA, Resectable pancreatic ductal adenocarcinoma, Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question, Gemcitabine.
Shares Resectable pancreatic ductal adenocarcinoma, Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question, Gemcitabine, Pancreatic ductal adenocarcinoma.
Shares Resectable pancreatic ductal adenocarcinoma, Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question, Fluorouracil (5-FU), Gemcitabine.
Shares ESPAC-3, Resectable pancreatic ductal adenocarcinoma, Fluorouracil (5-FU), Pancreatic ductal adenocarcinoma.
Shares JAMA, Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question, Gemcitabine, Pancreatic ductal adenocarcinoma.
Shares Fluorouracil (5-FU), Gemcitabine, Pancreatic ductal adenocarcinoma.
Shares Resectable pancreatic ductal adenocarcinoma, Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question, Gemcitabine, Pancreatic ductal adenocarcinoma.