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Published in: Journal of Cancer Research and Clinical Oncology 10/2012

01-10-2012 | Original Paper

Comparison of the efficacy and the toxicity between gemcitabine with capecitabine (GC) and gemcitabine with erlotinib (GE) in unresectable pancreatic cancer

Authors: Eun Kyoung Jeon, Hye-Sung Won, Yoon-Ho Ko, In Seok Lee, Tae Ho Hong, Young Kyoung You, Myung Ah Lee

Published in: Journal of Cancer Research and Clinical Oncology | Issue 10/2012

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Abstract

Objective

We retrospectively compared the efficacy and toxicity of gemcitabine combination with capecitabine or erlotinib in unresectable pancreatic cancer to know whether the combination with cytotoxic and target agent has more benefit comparing to combination of cytotoxic agents.

Methods

Fifty-three patients with unresectable pancreatic cancer, treated with gemcitabine and capecitabine (GC) or gemcitabine and erlotinib (GE) as first line between October 2006 and July 2010, were reviewed. In GC group, patients were treated with gemcitabine 1,000 mg/m2 on days 1, 8, and capecitabine 1,300 mg/m2 bid was administered on days 1–14, repeated every 21 days. In GE group, gemcitabine was given at 1,000 mg/m2 I.V for 30 min on days 1,8,15, and erlotinib was taken orally at 100 mg through days 1–28, repeated every 28 days.

Results

Response rate was similar, 23.5 % in GE and 21.1 % in GC, but GC had better disease control rate with 73.7 % than GE with 52.9 %. GC also showed longer PFS and OS (5.37 and 14.43 months) than GE (2.63 and 6.23 months) (p = 0.032 for PFS and 0.002 for OS). In toxicity profiles, GC had more hematologic toxicities and GE had more non-hematologic toxicities.

Conclusions

The combination with cytotoxic agents seems to have better efficacy and clinical outcome than combination with cytotoxic agent and target agent. The new combination should be developed for the treatment for advanced pancreatic cancer.
Literature
go back to reference Berlin JD, Catalano P, Thomas JP et al (2002) Phase III study of gemcitabine in combination with fluorouracil versus gemcitabine alone in patients with advanced pancreatic carcinoma: Eastern Cooperative Oncology Group Trial E2297. J Clin Oncol 20(15):3270–3275PubMedCrossRef Berlin JD, Catalano P, Thomas JP et al (2002) Phase III study of gemcitabine in combination with fluorouracil versus gemcitabine alone in patients with advanced pancreatic carcinoma: Eastern Cooperative Oncology Group Trial E2297. J Clin Oncol 20(15):3270–3275PubMedCrossRef
go back to reference Burris HA 3rd, Moore MJ, Andersen J et al (1997) Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial. J Clin Oncol 15(6):2403–2413PubMed Burris HA 3rd, Moore MJ, Andersen J et al (1997) Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial. J Clin Oncol 15(6):2403–2413PubMed
go back to reference Cartwright TH, Cohn A, Varkey JA et al (2002) Phase II study of oral capecitabine in patients with advanced or metastatic pancreatic cancer. J Clin Oncol 20(1):160–164PubMedCrossRef Cartwright TH, Cohn A, Varkey JA et al (2002) Phase II study of oral capecitabine in patients with advanced or metastatic pancreatic cancer. J Clin Oncol 20(1):160–164PubMedCrossRef
go back to reference Cunningham D, Chau I, Stocken DD et al (2009) Phase III randomized comparison of gemcitabine versus gemcitabine plus capecitabine in patients with advanced pancreatic cancer. J Clin Oncol 27(33):5513–5518PubMedCrossRef Cunningham D, Chau I, Stocken DD et al (2009) Phase III randomized comparison of gemcitabine versus gemcitabine plus capecitabine in patients with advanced pancreatic cancer. J Clin Oncol 27(33):5513–5518PubMedCrossRef
go back to reference Heinemann V, Quietzsch D, Gieseler F et al (2006) Randomized phase III trial of gemcitabine plus Cisplatin compared with gemcitabine alone in advanced pancreatic cancer. J Clin Oncol 24(24):3946–3952PubMedCrossRef Heinemann V, Quietzsch D, Gieseler F et al (2006) Randomized phase III trial of gemcitabine plus Cisplatin compared with gemcitabine alone in advanced pancreatic cancer. J Clin Oncol 24(24):3946–3952PubMedCrossRef
go back to reference Herrmann R, Bodoky G, Ruhstaller T et al (2007) Gemcitabine plus capecitabine compared with gemcitabine alone in advanced pancreatic cancer: a randomized, multicenter, phase III trial of the Swiss Group for Clinical Cancer Research and the Central European Cooperative Oncology Group. J Clin Oncol 25(16):2212–2217PubMedCrossRef Herrmann R, Bodoky G, Ruhstaller T et al (2007) Gemcitabine plus capecitabine compared with gemcitabine alone in advanced pancreatic cancer: a randomized, multicenter, phase III trial of the Swiss Group for Clinical Cancer Research and the Central European Cooperative Oncology Group. J Clin Oncol 25(16):2212–2217PubMedCrossRef
go back to reference Hess V, Salzberg M, Borner M et al (2003) Combining capecitabine and gemcitabine in patients with advanced pancreatic carcinoma: a phase I/II trial. J Clin Oncol 21(1):66–68PubMedCrossRef Hess V, Salzberg M, Borner M et al (2003) Combining capecitabine and gemcitabine in patients with advanced pancreatic carcinoma: a phase I/II trial. J Clin Oncol 21(1):66–68PubMedCrossRef
go back to reference Kindler HL, Niedzwiecki D, Hollis D et al (2010) Gemcitabine plus bevacizumab compared with gemcitabine plus placebo in patients with advanced pancreatic cancer: phase III trial of the Cancer and Leukemia Group B (CALGB 80303). J Clin Oncol 28(22):3617–3622 Kindler HL, Niedzwiecki D, Hollis D et al (2010) Gemcitabine plus bevacizumab compared with gemcitabine plus placebo in patients with advanced pancreatic cancer: phase III trial of the Cancer and Leukemia Group B (CALGB 80303). J Clin Oncol 28(22):3617–3622
go back to reference Louvet C, Labianca R, Hannel P et al (2005) Gemcitabine in combination with oxaliplatin compared with gemcitabine alone in locally advanced or metastatic pancreatic cancer: results of a GERCOR and GISCAD phase III trial. J Clin Oncol 23(15):3509–3516PubMedCrossRef Louvet C, Labianca R, Hannel P et al (2005) Gemcitabine in combination with oxaliplatin compared with gemcitabine alone in locally advanced or metastatic pancreatic cancer: results of a GERCOR and GISCAD phase III trial. J Clin Oncol 23(15):3509–3516PubMedCrossRef
go back to reference Matano E, Taqliaferri P, Libroia A et al (2000) Gemcitabine combined with continuous infusion 5- fluorouracil in advanced and symptomatic pancreatic cancer: a clinical benefit-oriented phase II study. Br J Cancer 82(11):1772–1775PubMedCrossRef Matano E, Taqliaferri P, Libroia A et al (2000) Gemcitabine combined with continuous infusion 5- fluorouracil in advanced and symptomatic pancreatic cancer: a clinical benefit-oriented phase II study. Br J Cancer 82(11):1772–1775PubMedCrossRef
go back to reference Moore MJ, Goldstein D, Hamm J et al (2007) Erlotinib plus gemcitabine compared with gemcitabine alone in patients with advanced pancreatic cancer: a phase III trial of the National Cancer Institute of Canada Clinical Trials Group. J Clin Oncol 25(15):1960–1966PubMedCrossRef Moore MJ, Goldstein D, Hamm J et al (2007) Erlotinib plus gemcitabine compared with gemcitabine alone in patients with advanced pancreatic cancer: a phase III trial of the National Cancer Institute of Canada Clinical Trials Group. J Clin Oncol 25(15):1960–1966PubMedCrossRef
go back to reference Oettle H, Richards D, Ramanathan RK et al (2005) A phase III trial of pemetrexed plus gemcitabine versus gemcitabine in patients with unresectable or metastatic pancreatic cancer. Ann Oncol 16(10):1639–1645PubMedCrossRef Oettle H, Richards D, Ramanathan RK et al (2005) A phase III trial of pemetrexed plus gemcitabine versus gemcitabine in patients with unresectable or metastatic pancreatic cancer. Ann Oncol 16(10):1639–1645PubMedCrossRef
go back to reference Park BB, Park JO, Lee HR et al (2007) A phase II trial of gemcitabine plus capecitabine for patients with advanced pancreatic adenocarcinoma. Cancer Chemother Pharmacol 60(4):489–494PubMedCrossRef Park BB, Park JO, Lee HR et al (2007) A phase II trial of gemcitabine plus capecitabine for patients with advanced pancreatic adenocarcinoma. Cancer Chemother Pharmacol 60(4):489–494PubMedCrossRef
go back to reference Philip PA, Benedetti J. Corless CL et al (2010) Phase III study comparing gemcitabine plus cetuximab versus gemcitabine in patients with advanced pancreatic adenocarcinoma: Southwest Oncology Group-directed intergroup trial S0205. J Clin Oncol 28(22):3605–3610 Philip PA, Benedetti J. Corless CL et al (2010) Phase III study comparing gemcitabine plus cetuximab versus gemcitabine in patients with advanced pancreatic adenocarcinoma: Southwest Oncology Group-directed intergroup trial S0205. J Clin Oncol 28(22):3605–3610
go back to reference Rauch DP, Maurer CA, Aebi S et al (2001) Activity of gemcitabine and continuous infusion fluorouracil in advanced pancreatic cancer. Oncology 60(1):43–48PubMedCrossRef Rauch DP, Maurer CA, Aebi S et al (2001) Activity of gemcitabine and continuous infusion fluorouracil in advanced pancreatic cancer. Oncology 60(1):43–48PubMedCrossRef
go back to reference Ren Q, Kao V, Grem JL (1998) Cytotoxicity and DNA fragmentation associated with sequential gemcitabine and 5-fluoro-2’-deoxyuridine in HT-29 colon cancer cells. Clin Cancer Res 4(11):2811–2818PubMed Ren Q, Kao V, Grem JL (1998) Cytotoxicity and DNA fragmentation associated with sequential gemcitabine and 5-fluoro-2’-deoxyuridine in HT-29 colon cancer cells. Clin Cancer Res 4(11):2811–2818PubMed
go back to reference Schilsky RL, Bertucci D, Vogelzang NJ et al (2002) Dose-escalating study of capecitabine plus gemcitabine combination therapy in patients with advanced cancer. J Clin Oncol 20(2):582–587PubMedCrossRef Schilsky RL, Bertucci D, Vogelzang NJ et al (2002) Dose-escalating study of capecitabine plus gemcitabine combination therapy in patients with advanced cancer. J Clin Oncol 20(2):582–587PubMedCrossRef
go back to reference Xie DR, Yang Q, Chen DL et al (2010) Gemcitabine-based cytotoxic doublets chemotherapy for advanced pancreatic cancer: updated subgroup meta-analyses of overall survival. Jpn J Clin Oncol 40(5):432–441 Xie DR, Yang Q, Chen DL et al (2010) Gemcitabine-based cytotoxic doublets chemotherapy for advanced pancreatic cancer: updated subgroup meta-analyses of overall survival. Jpn J Clin Oncol 40(5):432–441
Metadata
Title
Comparison of the efficacy and the toxicity between gemcitabine with capecitabine (GC) and gemcitabine with erlotinib (GE) in unresectable pancreatic cancer
Authors
Eun Kyoung Jeon
Hye-Sung Won
Yoon-Ho Ko
In Seok Lee
Tae Ho Hong
Young Kyoung You
Myung Ah Lee
Publication date
01-10-2012
Publisher
Springer-Verlag
Published in
Journal of Cancer Research and Clinical Oncology / Issue 10/2012
Print ISSN: 0171-5216
Electronic ISSN: 1432-1335
DOI
https://doi.org/10.1007/s00432-012-1234-y

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