The evaluation of efficacy and tolerability of gemcitabine vs. capecitabine therapy in the second-line setting for metastatic pancreatic cancer patients with poor performance status

Aim

The aim of this study was to evaluate the efficacy and tolerability of single-agent gemcitabine vs. capecitabine therapy in the second-line setting for metastatic Pancreatic Cancer (mPC) patients with poor performance status.

Material and methods

A total of 48 patients with mPC, who were followed and treated in oncology center between 2012 and 2017, were included. After a failure of first-line therapy, patients with an ECOG-PS 2 treated with capecitabine or gemcitabine monotherapy in the secondline setting were retrospectively analyzed.

Results

Of the 48 patients, 26(54.2%) were males and 22(45.8%) were females. The median age of the patients was 62 years(range, 31-82). Treatment regimens in the first-line setting were as follows; gemcitabine+cisplatin in 24(50%) patients, gemcitabine+nub-paclitaxel in 4(8.3%) patients, FOLFIRINOX in 8(16.7%) patients, FOLFOX in 8(16.7%) patients, and gemcitabine+oxaliplatine in 4(8.3%) patients. After progression on first-line therapy, 29(60.5%) patients were treated with capecitabine in the second-line setting, while 19(39.5%) patients were given gemcitabine. Median progression-free survival was found to be 4 months(95% CI,1.9-6.0) in patients receiving capecitabine compared to 2 months(95% CI, 0.5-3.4) in those treated with gemcitabine (p=0.271). Median overall survival was 6.0 months(95% CI, 2.0-9.9) in patients receiving capecitabine therapy versus 5.0 months (95% CI, 1.0-8.9) in those treated with gemcitabine monotherapy (p=0.353).

Conclusions

Optimal second-line treatment for mPC has not yet been established. In the present study, capecitabine monotherapy was compared to gemcitabine and it was found that they both had similar efficacy in the second-line treatment for mPC patients who were not eligible for combination chemotherapy regimen.