Pancreatic adenocarcinoma is diagnosed in more than 45,000 people each year, and less than 6% of these patients are expected to survive past 5 years; therefore, effective, safe treatments for the disease are paramount.
In an article recently published in the journal Cancer, researchers from Columbia University aimed to determine whether the neoadjuvant gemcitabine, docetaxel, and capecitabine (GTX) and gemcitabine and capecitabine (GX) with radiation therapy (RT) was appropriate for patients presenting with locally advanced, unresectable disease.
The study protocol was designed for GTX to shrink the tumor, thus allowing the tumors to be resected; GX with RT were then given to those presenting with arterial involvement to eradicate any tumor on the arterial margins. The researchers found that in 45 patients who were given either GTX or GX/RT, the treatments were tolerated with expected side effects.
In patients with arterial involvement who underwent resection, 20 achieved R0 (complete) resections. In the 11 patients with venous-only involvement, 8 achieved R0 resections and 3 complete pathologic response. Seventy-one percent of the total patients in this study were alive after 1 year, and median survival was 29 months. Thirteen patients have not relapsed, and in the venous arm, median survival has not been reached.
The authors concluded that GTX and GX/RT are effective regimens that can be safely administered in this setting, resulting in a high response rate and prolonged overall survival.
This prospective study was undertaken to assess toxicity, resectability, and survival in pancreatic adenocarcinoma patients presenting with locally advanced, unresectable disease treated with neoadjuvant gemcitabine, docetaxel, and capecitabine (GTX) and gemcitabine and capecitabine (GX)/radiation therapy (RT).