Cancer Treatment Today

The ESPAC-3 trial showed that adjuvant gemcitabine is the standard of care based on similar survival to and less toxicity than adjuvant 5-fluorouracil/folinic acid in patients with resected pancreatic cancer. Other clinical trials have shown better survival and tumour response with gemcitabine and capecitabine than with gemcitabine alone in advanced or metastatic pancreatic cancer.

In the recent Lancet article compating these two drugs adjuvantly to gemcitabine alone, the authors concluded that the adjuvant combination of gemcitabine and capecitabine should be the new standard of care following resection for pancreatic ductal adenocarcinoma. The median overall survival for patients in the gemcitabine plus capecitabine group was 28·0 months (95% CI 23·5–31·5) compared with 25·5 months (22·7–27·9) in the gemcitabine group (hazard ratio 0·82 [95% CI 0·68–0·98], p=0·032).

CCN, Pancreatic PNAC-G, 1 2016

T. Seufferlein, J.B. Bachet, E. Van Cutsem, P. Rougier and on behalf of the ESMO Guidelines W, Pancreatic adenocarcinoma: ESMOESDO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol (2012) 23 (suppl 7): vii33-vii40

Prof John P Neoptolemos, MD’Correspondence information about the author Prof John P NeoptolemosEmail the author Prof John P Neoptolemos, Prof Daniel H Palmer, PhD, Prof Paula Ghaneh, MD, Eftychia E Psarelli, MSc, Juan W Valle, MD, Christopher M Halloran, MD, Olusola Faluyi, MD, Derek A O’Reilly, MD, Prof David Cunningham, MD, Prof Jonathan Wadsley, MD, Suzanne Darby, MD, Prof Tim Meyer, MD, Roopinder Gillmore, MD, Alan Anthoney, MD, Pehr Lind, MD, Bengt Glimelius, MD, Stephen Falk, MD, Prof Jakob R Izbicki, MD, Gary William Middleton, MD, Sebastian, Comparison of adjuvant gemcitabine and capecitabine with gemcitabine monotherapy in patients with resected pancreatic cancer (ESPAC-4): a multicentre, open-label, randomised, phase 3 trial. Lancert Volume 389, No. 10073, p1011–1024, 11 March 2017