The results of a large pan-European study by the European Study Group for Pancreatic Cancer (ESPAC) involving 732 patients has shown that the combination of gemcitabine plus capecitabine adjuvant therapy (following successful resection of the tumour) significantly improved survival.
Presented at the American Society for Clinical Oncology1 in Chicago this week, the lead researchers from Liverpool, UK reported that in this phase III trial, 5-year survival on the gemcitabine and capecitabine combination was 28.8% versus 16.3% for the gemcitabine alone arm. Median survival was 28 months with gemcitabine and capecitabine versus 25.5 months in the gemcitabine alone arm.
While this is a modest increase, it is an important one, as survival for pancreatic cancer is still stubbornly low. What is of note is that the scientists reported that there was not a huge increase in side effects and therefore this combination is believed to be safe. Now that they know this, there is the possibility that further agents can be added to this combination in future trials to help boost survival.
It is important to note that the adjuvant chemotherapy is not the key determinant factor for long-time survival for operable pancreatic cancer. It is vital that patients are detected early and that when surgery is performed, the whole of the tumour is removed with clear margins.