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Saif MW, Ledbetter L, Kaley K, et al. Maintenance therapy with capecitabine in patients with locally advanced unresectable pancreatic adenocarcinoma. Oncol Lett. 2014;8(3):1302-1306doi: 10.3892/ol.2014.2238.
Saif, M. W., Ledbetter, L., Kaley, K., Garcon, M. C., Rodriguez, T., & Syrigos, K. N. (2014). Maintenance therapy with capecitabine in patients with locally advanced unresectable pancreatic adenocarcinoma. Oncology letters, 8(3), 1302-1306. https://doi.org/10.3892/ol.2014.2238
Saif, Muhammad Wasif, et al. "Maintenance therapy with capecitabine in patients with locally advanced unresectable pancreatic adenocarcinoma." Oncology letters vol. 8,3 (2014): 1302-1306. doi: https://doi.org/10.3892/ol.2014.2238
Saif MW, Ledbetter L, Kaley K, Garcon MC, Rodriguez T, Syrigos KN. Maintenance therapy with capecitabine in patients with locally advanced unresectable pancreatic adenocarcinoma. Oncol Lett. 2014 Sep;8(3):1302-1306. doi: 10.3892/ol.2014.2238. Epub 2014 Jun 11. PMID: 25120712; PMCID: PMC4114599.
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Oncol Lett. 2014 Sep;8(3):1302-1306. doi: 10.3892/ol.2014.2238. Epub 2014 Jun 11.

Maintenance therapy with capecitabine in patients with locally advanced unresectable pancreatic adenocarcinoma.

Oncology letters

Muhammad Wasif Saif, Leslie Ledbetter, Kristin Kaley, Marie Carmel Garcon, Teresa Rodriguez, Kostas N Syrigos

Affiliations

  1. Section of GI Cancers and Experimental Therapeutics, Tufts University School of Medicine, Boston, MA 02111, USA.
  2. University of Alabama at Birmingham, Birmingham, AL 35233, USA.
  3. Yale School of Medicine, New Haven, CT 06520, USA.
  4. Columbia University Medical Center, New York, NY 10027, USA.
  5. Oncology Unit, Third Department of Medicine, University of Athens, Sotiria General Hospital, Athens 115 27, Greece.

PMID: 25120712 PMCID: PMC4114599 DOI: 10.3892/ol.2014.2238

Abstract

Therapeutic options for locally advanced pancreatic cancer (LAPC) include concurrent chemoradiation, induction chemotherapy followed by chemoradiation or systemic therapy alone. The original Gastro-Intestinal Study Group and Eastern Cooperative Oncology Group studies defined fluorouracil (5-FU) with concurrent radiation therapy followed by maintenance 5-FU until progression, as the standard therapy for this subset of patients. Although this combined therapy has been demonstrated to increase local control and median survival from 8 to 12 months, almost all patients succumb to the disease secondary to either local or distant recurrence. Our earlier studies provided a strong rationale for the use of capecitabine in combination with concurrent radiation followed by maintenance capecitabine therapy. To report our clinical experience, we retrospectively evaluated our patients who were treated with maintenance capecitabine. We reviewed the medical records of patients with LAPC who received treatment with capecitabine and radiation, followed by a 4-week rest, then capecitabine alone 1,000 mg twice daily (ECOG performance status 2 or age >70 years) or 1,500 mg twice daily for 14 days every 3 weeks until progressive disease. We treated 43 patients between September 2004 and September 2012. The population consisted of 16 females and 25 males, with a median age of 64 years (range, 38-80 years). Patients received maintenance capecitabine for median duration of 9 months (range, 3-18 months). The median overall survival (OS) for these patients was 17 months, with two patients still living and receiving therapy. The 6-month survival rate was 91% (39/43), 1-year survival rate was 72% (31/43) and 2-year OS rate was 26% (11/43). Grade 3 or 4 toxicity was observed rarely: Hand-foot syndrome (HFS) in two patients, diarrhea in one patient and peripheral neuropathy in one patient, and there was no mortality directly related to treatment. Capecitabine maintenance therapy following chemoradiation in LAPC offers an effective, tolerable and convenient alternative to 5-FU. To the best of our knowledge, this is the largest study of its kind which has determined the safety and efficacy of capecitabine maintenance therapy for patients with LAPC.

Keywords: capecitabine (Xeloda); pancreatic cancer; radiotherapy; thymidine phosphorylase

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