Capecitabine and Gemcitabine help battle pancreatic cancer

The prognosis of pancreatic cancer is poor but new therapies such as gemcitabine have contributed to improving the outcome for patients. Data presented at the 13th European Conference (ECCO) revealed that using the combination of gemcitabine and capecitabine increased overall survival in some patients.

Between May 2003 and January 2005, 533 patients with previously untreated or cytological proven locally advanced/metastatic carcinoma of the pancreas were randomised to receive either gemcitabine treatment alone, or gemcitabine and capecitabine treatment. Treatment continued until the disease progressed or the side effects/toxicity effects became intolerable. The primary outcome was survival.

At the time of the interim analysis in May 2005, 70% of deaths had occurred. The median survival for gemcitabine alone and gemcitabine and capecitabine was 6 months and 7.4 months respectively but 1-year survival rates were 19% and 26% respectively. Toxicity effects recorded in both treatment groups included anaemia, neutropenia, thrombocytopenia, fever, diarrhoea and vomiting.

The investigators concluded there was a significant improvement in overall survival by the addition of capecitabine to gemcitabine over gemcitabine alone in advanced pancreatic cancer with acceptable levels of toxicity.

Dr Ian Chau from the Royal Marsden Hospital, UK, commented, "The combination of gemcitabine and capecitabine confers a survival advantage over standard gemcitabine monotherapy and may be considered as a new standard of care in advanced pancreatic cancer. Patients will enjoy an improvement in survival with an acceptable level of side effects. This combination could form a new treatment platform to which novel molecular targeted therapy can be added."

Pancreatic cancer is a very aggressive cancer with an extremely low survival rate. It is very difficult to detect and can be without symptoms until it has reached an advanced stage; most patients die within 6 months of diagnosis.

Pancreatic cancer is the tenth most frequently occurring cancer in Europe. It is associated with smoking tobacco and does have a strong hereditary component. It does not usually appear before the age of forty. There are many types of cancer but the vast majority are exocrine type (affect the release of pancreatic enzymes for the digestive system), others affect the endocrine system, the release of hormones such as insulin.

Pancreatic cancer is difficult to treat and is often resistant to chemotherapy and radiotherapy. Normally surgical removal of the cancer is the best chance for patients and the most widely used surgical technique is called a pancreaticoduodenectomy (PD) or Whipple procedure. However, newer drugs in clinical trials and chemotherapy options such as the administration of gemcitabine and capectiabine are offering patients some treatment options.