Expanded phase II trial of gemcitabine and capecitabine for advanced biliary cancer

• Published in: Cancer 2007-09, Vol.110 (6), p.1307-1312
• Main Authors: Riechelmann, Rachel P., Townsley, Carol A., Chin, Sheray N., Pond, Gregory R., Knox, Jennifer J.
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - drug therapy; Adenocarcinoma - pathology; Adult; advanced biliary cancer; Aged; Aged, 80 and over; Antimetabolites, Antineoplastic - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Bile Duct Neoplasms - drug therapy; Biliary Tract Neoplasms - drug therapy; Biliary Tract Neoplasms - pathology; Biological and medical sciences; Capecitabine; Deoxycytidine - administration & dosage; Deoxycytidine - analogs & derivatives; Disease-Free Survival; Drug Administration Schedule; Female; Fluorouracil - administration & dosage; Fluorouracil - analogs & derivatives; Follow-Up Studies; Gallbladder Neoplasms - drug therapy; gemcitabine; Humans; Male; Medical sciences; Middle Aged; objective response; overall survival; progression‐free survival; Survival Analysis; Treatment Outcome; Tumors
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.22902

BACKGROUND. A phase 2 trial of gemcitabine and capecitabine (GemCap) in patients with advanced biliary cancer led to an objective response in approximately 30% of patients and a median survival of 14 months. In the current study, the authors report further efficacy data of a larger cohort of such patients treated with the GemCap regimen. METHODS. Patients aged >18 years and who had a diagnosis of locally advanced biliary cancer received first‐line treatment with capecitabine at a dose of 650 mg/m2 twice daily for 14 days and gemcitabine at a dose of 1000 mg/m2 on Day 1 and Day 8, every 3 weeks until disease progression. Tumor response was assessed by Response Evaluation Criteria In Solid Tumors (RECIST) criteria. RESULTS. Between July 2001 and January 2005, 75 patients were enrolled in the study. At a median follow‐up of 9.5 months, the overall response rate was 29% (95% confidence interval [95% CI], 19.4–41%), with a median duration of 9.7 months (range, 3–36 months). Three patients achieved complete responses, with a median duration of 17 months (range, 9–27 months). The median progression‐free survival and overall survivals were 6.2 months (95% CI, 4.4–8.3 months) and 12.7 months (95% CI, 9.5–31 months), respectively. CONCLUSIONS. The GemCap regimen is active in patients with biliary cancer. Randomized trials are warranted to define the impact of such a regimen on patient survival and quality of life. Cancer 2007. © 2007 American Cancer Society. An expanded phase 2 trial of gemcitabine and capecitabine in 75 patients with advanced biliary cancer led to an objective response in 29% of patients, with a median duration of 9.7 months and a median survival of 12.7 months. Patients with gallbladder cancer had shorter progression‐free and overall survivals compared with patients with cholangiocarcinoma.