Abstract
The role of second-line therapy in metastatic pancreatic cancer is not clear. In this study, we aimed to explore the second-line efficiency of capecitabine and oxaliplatin (XELOX) in patients with advanced pancreatic cancer who have received gemcitabine-based first-line therapy. We retrospectively evaluated 47 patients with locally advanced or metastatic pancreatic cancer previously treated with gemcitabine-based first-line regimens. Treatment consisted of oxaliplatin 130 mg/m2 and capecitabine 1000 mg/m2 twice daily with a 3 week interval, until unacceptable toxicity or disease progression. Median number of cycles was 4 (range, 2-10). The overall disease control rate was 38.3%. The median overall survival and progression-free survival from the start of second-line therapy were 23 weeks (95%CI: 16.6-29.5 weeks) and 12 weeks (95%CI: 9.8-14.4 weeks), respectively. The most common grade 3-4 toxicities were nausea, vomiting and hematologic side effects. Our result suggests that the combination of capecitabine and oxaliplatin was tolerated with manageable toxicity and showed encouraging activity as second-line treatment of advanced or metastatic pancreatic cancer patients with ECOG performance status 0-2.
Highlights
Pancreatic adenocarcinoma is the seventh most common cancer and represents about 3% of all new cancer diagnoses
Our result suggests that the combination of capecitabine and oxaliplatin was tolerated with manageable toxicity and showed encouraging activity as second-line treatment of advanced or metastatic pancreatic cancer patients with Eastern Cooperative Oncology Group (ECOG) performance status 0-2
Most patients die from the disease because of its propensity for late presentation with advance stage, aggressive tumor biology and resistance to chemotherapy
Summary
Pancreatic adenocarcinoma is the seventh most common cancer and represents about 3% of all new cancer diagnoses. 5-FU has been used in treatment of metastatic pancreatic cancer patients for several decades and capecitabine is an oral pro-drug of 5-FU. Oxaliplatin and capecitabine combination is an effective and welltolerated regimen for metastatic colorectal cancer, but there is limited experience for treatment of pancreatic. Asian Pacific Journal of Cancer Prevention, Vol 15, 2014 7119 cancer Both oxaliplatine and capecitabine have been used as components of front-line therapy for metastatic pancreatic cancer (Conroy et al, 2011; Choi et al, 2012). The purpose of this study was to evaluate the efficiency of palliative chemotherapy including capecitabine and oxaliplatine (XELOX) for patients with advanced pancreatic cancer that has progressed after gemcitabinebased treatments. SPSS for Windows version 18.0 (SPSS Inc., Chicago, IL., USA) was employed for the data analysis
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