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

Abstract

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 withpoor performance status.Material and methods: A total of 48 patients with mPC, who were followed and treated in oncologycenter between 2012 and 2017, were included. After a failure of first-line therapy, patients with an ECOGPS 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 thepatients 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, FOLFIRINOXin 8(16.7%) patients, FOLFOX in 8(16.7%) patients, and gemcitabine+oxaliplatine in 4(8.3%) patients. Afterprogression on first-line therapy, 29(60.5%) patients were treated with capecitabine in the second-linesetting, while 19(39.5%) patients were given gemcitabine. Median progression-free survival was found tobe 4 months(95% CI,1.9-6.0) in patients receiving capecitabine compared to 2 months(95% CI, 0.5-3.4) inthose treated with gemcitabine (p¼0.271). Median overall survival was 6.0 months(95% CI, 2.0-9.9) inpatients receiving capecitabine therapy versus 5.0 months (95% CI, 1.0-8.9) in those treated with gemcitabine monotherapy (p¼0.353).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 similarefficacy in the second-line treatment for mPC patients who were not eligible for combination chemotherapy regimen.