There is no universally accepted standard approach to treat patients with pancreatic cancer in the adjuvant setting. This controversy derives from several studies, each fraught with its own limitations.
NCCN provides several choices, among them gemcitabine and capecitabine, Adjuvant gemcitabine plus capecitabine significantly improved overall survival compared with gemcitabine monotherapy in patients with pancreatic ductal adenocarcinoma, according to results of the ESPAC-4 trial presented at the American Society of Clinical Oncology (ASCO) 2016 Annual Meeting.
Regine, W. F., Winter, K. A., Abrams, R. A., Safran, H., Hoffman, J. P., Konski, A., Benson, A. B., Macdonald, J. S., Kudrimoti, M. R., Fromm, M. L., Haddock, M. G., Schaefer, P., Willett, C. G., Rich, T. A. (2008). Fluorouracil vs Gemcitabine Chemotherapy Before and After Fluorouracil-Based Chemoradiation Following Resection of Pancreatic Adenocarcinoma: A Randomized Controlled Trial. JAMA 299: 1019-1026
Benson, A. B. III (2007). Adjuvant Therapy for Pancreatic Cancer: One Small Step Forward. JAMA 297: 311-313
Neoptolemos JP, Palmer D, Ghaneh P, et al. ESPAC-4: A multicenter, international, open-label randomized controlled phase III trial of adjuvant combination chemotherapy of gemcitabine (GEM) and capecitabine (CAP) versus monotherapy gemcitabine in patients with resected pancreatic ductal adenocarcinoma. Oral presentation at: ASCO 2016 Annual Meeting; June 3-7, 2016; Chicago, IL.
nccn, Pancreatic 2017, PANC-5 and PANC-J