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Gemcitabine plus capecitabine (Gem-Cape) biweekly in chemorefractory metastatic colorectal cancer.

Jiménez-Fonseca P, Solis MP, Garrido M, Faez L, Rodriguez D, Ruiz AL, Sanchez Lorenzo ML, Uriol E, Menendez MD, Viéitez JM - Clin Transl Oncol (2014)

Bottom Line: Objective response rates and stable disease rates at 3 months were 6.72 and 37.81 %, equalling a clinical benefit of 44.53 %.Statistical significance was obtained by subgroups, assessing clinical benefits and objective responses for PFS and OS.These data suggest that Gem-Cape is a tolerable and feasible regimen, associated with clinical benefit in non-selected, heavily pretreated, mCRC patients.

View Article: PubMed Central - PubMed

Affiliation: Medical Oncology Department, Asturias Central University Hospital, Carretera de Rubín s/n Finca "La Cadellada", 33011, Oviedo, Asturias, Spain, palucaji@hotmail.com.

ABSTRACT

Purpose: A proportion of patients with metastatic colorectal cancer (mCRC) are still able to continue with active therapy after their progression to fluoropyrimidines, oxaliplatin, and irinotecan regimens. Studies suggest that gemcitabine and fluoropyrimidines are synergic antimetabolites. The purpose was to evaluate gemcitabine-capecitabine (Gem-Cape) in heavily pretreated mCRC and to thus assess possible predictive factors for progression-free survival (PFS) and overall survival (OS).

Patients and methods: This analysis was performed on 119 evaluable patients pretreated with fluoropyrimidines, oxaliplatin, irinotecan, and biological agents between June 2001 and July 2011. Patients received gemcitabine 1,000 mg/m(2) day 1 and capecitabine 1,000 mg/m(2) bid for 7 days every 2 weeks.

Results: The general characteristics were ECOG 0-1, 89 %; male, 68 %, and median age 63 years. In total, 61 % had received two chemotherapy lines, while 39 % had received three or more. Objective response rates and stable disease rates at 3 months were 6.72 and 37.81 %, equalling a clinical benefit of 44.53 %. The median PFS and OS were 2.87 months [95 % confidence interval (CI) 2.53-3.17 months] and 6.53 months (95 % CI 5.33-8.77), respectively. The most frequent toxicities were grades 1-2, anemia (22 %), thrombocytopenia (10 %), and hand-foot syndrome (9 %); grade ≥3, diarrhea (2 %), with no treatment-related discontinuations. No treatment-related deaths were reported. Statistical significance was obtained by subgroups, assessing clinical benefits and objective responses for PFS and OS. Moreover, patients under 65 tended to have a better PFS.

Conclusion: These data suggest that Gem-Cape is a tolerable and feasible regimen, associated with clinical benefit in non-selected, heavily pretreated, mCRC patients.

No MeSH data available.


Related in: MedlinePlus

Kaplan–Meier survival curves for OS (a, left panel), PFS (b, right panel) and according to K-ras mutation status (c)
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Fig2: Kaplan–Meier survival curves for OS (a, left panel), PFS (b, right panel) and according to K-ras mutation status (c)

Mentions: The median PFS was 2.87 months (95 % CI 2.53–3.17) and the median OS was 6.53 months (95 % CI 5.33–8.77). The survival rate was 50 % at 6 months and 25 % at the first year. Figure 2a–b shows the Kaplan–Meier estimation for PFS (A) and OS (B).Fig. 2


Gemcitabine plus capecitabine (Gem-Cape) biweekly in chemorefractory metastatic colorectal cancer.

Jiménez-Fonseca P, Solis MP, Garrido M, Faez L, Rodriguez D, Ruiz AL, Sanchez Lorenzo ML, Uriol E, Menendez MD, Viéitez JM - Clin Transl Oncol (2014)

Kaplan–Meier survival curves for OS (a, left panel), PFS (b, right panel) and according to K-ras mutation status (c)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4544491&req=5

Fig2: Kaplan–Meier survival curves for OS (a, left panel), PFS (b, right panel) and according to K-ras mutation status (c)
Mentions: The median PFS was 2.87 months (95 % CI 2.53–3.17) and the median OS was 6.53 months (95 % CI 5.33–8.77). The survival rate was 50 % at 6 months and 25 % at the first year. Figure 2a–b shows the Kaplan–Meier estimation for PFS (A) and OS (B).Fig. 2

Bottom Line: Objective response rates and stable disease rates at 3 months were 6.72 and 37.81 %, equalling a clinical benefit of 44.53 %.Statistical significance was obtained by subgroups, assessing clinical benefits and objective responses for PFS and OS.These data suggest that Gem-Cape is a tolerable and feasible regimen, associated with clinical benefit in non-selected, heavily pretreated, mCRC patients.

View Article: PubMed Central - PubMed

Affiliation: Medical Oncology Department, Asturias Central University Hospital, Carretera de Rubín s/n Finca "La Cadellada", 33011, Oviedo, Asturias, Spain, palucaji@hotmail.com.

ABSTRACT

Purpose: A proportion of patients with metastatic colorectal cancer (mCRC) are still able to continue with active therapy after their progression to fluoropyrimidines, oxaliplatin, and irinotecan regimens. Studies suggest that gemcitabine and fluoropyrimidines are synergic antimetabolites. The purpose was to evaluate gemcitabine-capecitabine (Gem-Cape) in heavily pretreated mCRC and to thus assess possible predictive factors for progression-free survival (PFS) and overall survival (OS).

Patients and methods: This analysis was performed on 119 evaluable patients pretreated with fluoropyrimidines, oxaliplatin, irinotecan, and biological agents between June 2001 and July 2011. Patients received gemcitabine 1,000 mg/m(2) day 1 and capecitabine 1,000 mg/m(2) bid for 7 days every 2 weeks.

Results: The general characteristics were ECOG 0-1, 89 %; male, 68 %, and median age 63 years. In total, 61 % had received two chemotherapy lines, while 39 % had received three or more. Objective response rates and stable disease rates at 3 months were 6.72 and 37.81 %, equalling a clinical benefit of 44.53 %. The median PFS and OS were 2.87 months [95 % confidence interval (CI) 2.53-3.17 months] and 6.53 months (95 % CI 5.33-8.77), respectively. The most frequent toxicities were grades 1-2, anemia (22 %), thrombocytopenia (10 %), and hand-foot syndrome (9 %); grade ≥3, diarrhea (2 %), with no treatment-related discontinuations. No treatment-related deaths were reported. Statistical significance was obtained by subgroups, assessing clinical benefits and objective responses for PFS and OS. Moreover, patients under 65 tended to have a better PFS.

Conclusion: These data suggest that Gem-Cape is a tolerable and feasible regimen, associated with clinical benefit in non-selected, heavily pretreated, mCRC patients.

No MeSH data available.


Related in: MedlinePlus