Cancer Res Treat.  2015 Apr;47(2):259-265. 10.4143/crt.2013.230.

Comparison of the Efficacy between Gemcitabine-Cisplatin and Capecitabine-Cisplatin Combination Chemotherapy for Advanced Biliary Tract Cancer

• Lee J
• Hong TH
• Lee IS
• You YK
• Lee MA

• KMID: 2132804
• DOI: http://doi.org/10.4143/crt.2013.230

Abstract

PURPOSE
Gemcitabine-cisplatin combination chemotherapy has been regarded as standard regimen for advanced or metastatic biliary tract cancer (BTC), based on the ABC-02 trial. To date, however, no studies have compared the efficacies of gemcitabine-platinum and fluoropyrimidine- platinum combination chemotherapy, even though fluoropyrimidine has been widely used as a backbone agent for gastrointestinal cancer. This study compared the efficacy and toxicities of gemcitabine-cisplatin (GP) and capecitabine-cisplatin (XP) combination chemotherapy for treatment of advanced BTC.
MATERIALS AND METHODS
We examined 49 patients treated with GP and 44 patients treated with XP from October 2009 to July 2012. All patients had unresectable BTC. The GP regimen comprised gemcitabine (1,000 mg/m2, intravenously [IV], days 1 and 8) and cisplatin (75 mg/m2, IV, day 1). The XP regimen comprised capecitabine (1,250 mg/m2 twice a day, peroral, days 1-14) and cisplatin (60 mg/m2, IV, day 1, every three weeks). We analyzed the response rate (RR), time to progression (TTP), overall survival (OS), and toxicity.
RESULTS
The RRs were 27.3% and 6.1% in the XP and GP arms, respectively. XP resulted in longer TTP (5.2 months vs. 3.6 months, p=0.016), but OS was not statistically different (10.7 months vs. 8.6 months, p=0.365). Both regimens resulted in grade 3-4 hematologic toxicities, but febrile neutropenia was not noted. Grade 3-4 asthenia, stomatitis, and hand-foot syndrome occurred more frequently in the XP arm.
CONCLUSION
XP resulted in a superior TTP and RR compared to GP for treatment of advanced BTC, with comparable toxicity. Conduct of prospective large, randomized trials to evaluate the possibility of XP as another standard therapy is warranted.

Keyword

Biliary tract neoplasms; Gemcitabine; Capecitabine; Cisplatin

MeSH Terms

Arm
Asthenia
Biliary Tract Neoplasms*
Cisplatin
Drug Therapy, Combination*
Febrile Neutropenia
Gastrointestinal Neoplasms
Hand-Foot Syndrome
Humans
Platinum
Stomatitis
Cisplatin
Platinum

Figure

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  Fig. 1. Comparison of survival outcomes between the capecitabine-cisplatin (XP) and gemcitabine-cisplatin (GP) regimen.

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  Fig. 2. Survival outcomes in patients older than 70 years.

Reference

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