Comparison of the efficacy between the gemcitabine/cisplatin (GP) and capecitabine/cisplatin (XP) for the advanced biliary tract cancer: Retrospective analysis in a single institution.

Abstract

365 Background: Bile duct cancers (BTC) are known to be the chemotherapy resistant cancer, and more common in old-age group. Gemcitabine and cisplatin (GP) has been widely used as first line treatment for unresectable BTC. Capecitabine and cisplatin (XP) combination chemotherapy has been also used as another option treatment. We retrospectively compared the efficacy of GP and XP for advanced BTC. Methods: Between Jan, 2009 and Jun, 2011, Fifty five patients who were diagnosed with unresectable BTC at Seoul St. Mary’s hospital were enrolled for analysis of the efficacy in the present study. All the patients had recurrent disease or metastatic cancer, confirmed by histologically adenocarcima. In GP group, gemcitabine was given with 1,000mg/m2, I.V for 30min on d1 and d8, and cisplatin was injected with 75mg/m2, d1, repeated every 21 days. In XP group, capecitabine was administered by orally 2,000mg/m2, divided dose d1-14, and cisplatin was administerd with 75mg/m2, d1, repeated every 21 days. Response evaluation with CT scan was taken after 2 cycles. Results: Of the 55 patients enrolled, 28 patients were treated with GP and 27 patients were treated with XP. Median age was 69 years old in GP, 65 years old in XP. Median number of cycle was 2.5 in both groups. There was no difference in patients’ characteristics between two groups in terms of sex, age, number of cycle and disease status. In analysis of the response rate, Partial response rate was 38.5% in XP, and 7.1% in GP, and stable disease was achieved in 23.1% in XP, 42.9% in GP (p=0.004). Median time to progression was 2.0 mon in GP, and 4 mon in XP (P=0.147). However, median survival time was 6 months vs. 4. 3months in GP and XP, respectively (p=0.510). There was no difference in toxicity between two groups. Conclusions: GP and XP showed similar clinical outcome, such as TTP or OS, although XP had significantly better response rate. These two regimens had modest activity, but not effective in terms of TTP or OS. Median number of cycles was only 2.5 in both groups because most patients were over 65 years old, and had poor performance status. Development of new effective regimens in advanced BTC should be warranted.