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Adding the tablet capecitabine to gemcitabine after surgery for pancreatic cancer lengthened median survival by about two and a half months with little extra toxicity, giving patients who cannot manage FOLFIRINOX a better option than gemcitabine alone.
Open-label randomised phase 3 trial by the European Study Group for Pancreatic Cancer in 730 patients from 92 hospitals who had undergone complete macroscopic resection of pancreatic ductal adenocarcinoma. Patients received six cycles of gemcitabine alone or gemcitabine plus oral capecitabine.
Median overall survival was 28.0 months with the combination against 25.5 months with gemcitabine alone (hazard ratio 0.82). Five-year survival was higher with the combination, and grade 3 or 4 adverse events were similar between the arms apart from more hand-foot syndrome and diarrhoea with capecitabine.
Gemcitabine plus capecitabine became the adjuvant regimen for patients unfit for modified FOLFIRINOX, and remains the comparator in European trials of adjuvant treatment.
Shares ESPAC-4, Resectable pancreatic ductal adenocarcinoma, Gemcitabine, Pancreatic ductal adenocarcinoma.
Shares Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question, Capecitabine, 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.
Shares ESPAC-4, Resectable pancreatic ductal adenocarcinoma, 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, Capecitabine, 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 ESPAC-4, Capecitabine, Gemcitabine, Pancreatic ductal adenocarcinoma.
Shares Resectable pancreatic ductal adenocarcinoma, Capecitabine, Gemcitabine.