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Capecitabine Instead of Gemcitabine in Locally Advanced Pancreatic Cancer ?

Overshadowed perhaps by the positive results of Von Hoff and colleagues’ research on Abraxane plus gemcitabine for advanced pancreatic cancer (ductal adenocarcinoma of the pancreas), an interesting study on the treatment of LOCALLY ADVANCED pancreatic cancer was presented at the recent ASCO Gastrointestinal Cancers Symposium in San Francisco late January.

In locally advanced cancer of the pancreas the treatment is generally chemoradiotherapy, meaning radiation therapy plus chemotherapy – the chemo often being the drug-agent gemcitabine.

Mukherjee of Oxford University and British colleagues presented a meeting abstract of the results of their work on a Phase II clinical trial that showed a modest survival advantage by using capecitabine (Xeloda) as compared to gemcitabine as the chemotherapy component of chemoradiation for locally advanced pancreatic cancer.  The results were later published in the April, 2013 issue of The Lancet, Oncology journal.

Capecitabine is a pro-drug that is converted into 5-FU by the body. It has the advantage of being given orally.  The study results by Mukherjee indicated that the regimen that included capecitabine offered less side-effects as compared to that of the gemcitabine regimen.

It will be interesting to see this work followed-up in other peer-reviewed medical journals – to see if the results will be replicated over time.


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Dale O’Brien, MD