Skip to main content
Erschienen in: Cancer Chemotherapy and Pharmacology 6/2011

01.12.2011 | Original Article

A phase II trial of gemcitabine and capecitabine in patients with unresectable or metastatic gallbladder cancer or cholangiocarcinoma: Southwest Oncology Group study S0202

verfasst von: Syma Iqbal, Cathryn Rankin, Heinz-Josef Lenz, Philip J. Gold, Syed A. Ahmad, Anthony B. El-Khoueiry, Michael J. Messino, Randall F. Holcombe, Charles D. Blanke

Erschienen in: Cancer Chemotherapy and Pharmacology | Ausgabe 6/2011

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Patients with gallbladder cancer or cholangiocarcinoma were treated with the combination of gemcitabine 1,000 mg/m2 IV over 100 min on days 1 and 8 and capecitabine 650 mg/m2 BID PO on days 1–14, administered every 21 days.

Methods

The primary objective of this study was to assess the response rate (confirmed complete and partial responses) of gemcitabine and capecitabine used in advanced/metastatic biliary neoplasms. Secondary objectives included overall survival and toxicities.

Results

The study accrued 57 patients from September 2003 to April 2005. Three patients were ineligible, and two others received no treatment. Characteristics of analyzable patients: 35 (67%) cholangiocarcinoma, 17 (33%) gallbladder cancer; PS 0 (18 pts), 1 (26 pts), 2 (8 pts); 26 (50%) men; median age 58.8 years (29.5–85.6). Among 51 patients evaluated for toxicity, 6 experienced grade 4 toxicities. Among 52 patients, there were 7 confirmed partial responses for a confirmed response probability of 13% (95% CI: 6–26%). Six patients had an unconfirmed partial response for an overall response probability of 25% (95% CI: 14–39%). Twelve patients (23%) demonstrated stable disease. The 6-month overall survival was 55% (95% CI: 41–69%), and median survival was 7 months (95% CI: 5–8 months).

Conclusions

The combination of gemcitabine and capecitabine is a well-tolerated regimen with activity in patients with advanced gallbladder cancer and cholangiocarcinoma.
Literatur
1.
Zurück zum Zitat American Cancer Society (2010). Cancer facts & figures. American Cancer Society, Atlanta American Cancer Society (2010). Cancer facts & figures. American Cancer Society, Atlanta
2.
Zurück zum Zitat Serra I, Calvo A, Baez S et al (1996) Risk factors for gallbladder cancer. An international collaborative case-control study. Cancer 78:1515–1517 Serra I, Calvo A, Baez S et al (1996) Risk factors for gallbladder cancer. An international collaborative case-control study. Cancer 78:1515–1517
3.
Zurück zum Zitat Falkson G, MacIntyre JM, Moertel CG (1984) Eastern Cooperative Oncology Group experience with chemotherapy for inoperable gallbladder and bile duct cancer. Cancer 54:965–969PubMedCrossRef Falkson G, MacIntyre JM, Moertel CG (1984) Eastern Cooperative Oncology Group experience with chemotherapy for inoperable gallbladder and bile duct cancer. Cancer 54:965–969PubMedCrossRef
4.
Zurück zum Zitat Takada T, Kato H, Matsushiro T et al (1996) Prospective randomized trial comparing 1/2 FAM (5-fluorouracil (5-FU) + adriamycin + mitomycin C) versus palliative therapy for the treatment of unresectable pancreatic and biliary tract carcinomas (the 2nd trial in non-resectable patients). Japanese Study Group of Surgical Adjuvant Therapy for Carcinomas of the Pancreas and Biliary Tract. Gan To Kagaku Ryoho 23:707–714 Takada T, Kato H, Matsushiro T et al (1996) Prospective randomized trial comparing 1/2 FAM (5-fluorouracil (5-FU) + adriamycin + mitomycin C) versus palliative therapy for the treatment of unresectable pancreatic and biliary tract carcinomas (the 2nd trial in non-resectable patients). Japanese Study Group of Surgical Adjuvant Therapy for Carcinomas of the Pancreas and Biliary Tract. Gan To Kagaku Ryoho 23:707–714
5.
Zurück zum Zitat Kajanti M, Pyrhonen S (1994) Epirubicin-sequential methotrexate-5-fluorouracil-leucovorin treatment in advanced cancer of the extrahepatic biliary system. A phase II study. Am J Clin Oncol 17:223–226PubMedCrossRef Kajanti M, Pyrhonen S (1994) Epirubicin-sequential methotrexate-5-fluorouracil-leucovorin treatment in advanced cancer of the extrahepatic biliary system. A phase II study. Am J Clin Oncol 17:223–226PubMedCrossRef
6.
Zurück zum Zitat Patt YZ, Jones DV Jr, Hoque A et al (1996) Phase II trial of intravenous flourouracil and subcutaneous interferon alfa-2b for biliary tract cancer. J Clin Oncol 14:2311–2315 Patt YZ, Jones DV Jr, Hoque A et al (1996) Phase II trial of intravenous flourouracil and subcutaneous interferon alfa-2b for biliary tract cancer. J Clin Oncol 14:2311–2315
7.
Zurück zum Zitat Sanz-Altamira PM, Ferrante K, Jenkins RL et al (1998) A phase II trial of 5-fluorouracil, leucovorin, and carboplatin in patients with unresectable biliary tree carcinoma. Cancer 82:2321–2325 Sanz-Altamira PM, Ferrante K, Jenkins RL et al (1998) A phase II trial of 5-fluorouracil, leucovorin, and carboplatin in patients with unresectable biliary tree carcinoma. Cancer 82:2321–2325
8.
Zurück zum Zitat Verderame F, Mandina P, Abruzzo F et al (2000) Biliary tract cancer: our experience with gemcitabine treatment. Anticancer Drugs 11:707–708PubMedCrossRef Verderame F, Mandina P, Abruzzo F et al (2000) Biliary tract cancer: our experience with gemcitabine treatment. Anticancer Drugs 11:707–708PubMedCrossRef
9.
Zurück zum Zitat Castro MP (1998) Efficacy of gemcitabine in the treatment of patients with gallbladder carcinoma: a case report. Cancer 82:639–641PubMedCrossRef Castro MP (1998) Efficacy of gemcitabine in the treatment of patients with gallbladder carcinoma: a case report. Cancer 82:639–641PubMedCrossRef
10.
Zurück zum Zitat Eng C, Ramanathan RK, Wong MK et al (2004) A phase II trial of fixed dose rate gemcitabine in patients with advanced biliary tree carcinoma. Am J Clin Oncol 27:565–569 Eng C, Ramanathan RK, Wong MK et al (2004) A phase II trial of fixed dose rate gemcitabine in patients with advanced biliary tree carcinoma. Am J Clin Oncol 27:565–569
11.
Zurück zum Zitat Valle J, Wasan H, Palmer DH et al (2010) Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer. N Engl J Med 362:1273–1281 Valle J, Wasan H, Palmer DH et al (2010) Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer. N Engl J Med 362:1273–1281
12.
Zurück zum Zitat Eckel F, Schmid RM (2007) Chemotherapy in advanced biliary tract carcinoma: a pooled analysis of clinical trials. Br J Cancer 96:896–902PubMedCrossRef Eckel F, Schmid RM (2007) Chemotherapy in advanced biliary tract carcinoma: a pooled analysis of clinical trials. Br J Cancer 96:896–902PubMedCrossRef
13.
Zurück zum Zitat Braakhuis BJ, Ruiz van Haperen VW, Boven E et al (1995) Schedule-dependent antitumor effect of gemcitabine in in vivo model system. Semin Oncol 22:42–46 Braakhuis BJ, Ruiz van Haperen VW, Boven E et al (1995) Schedule-dependent antitumor effect of gemcitabine in in vivo model system. Semin Oncol 22:42–46
14.
Zurück zum Zitat Tempero M, Plunkett W, Ruiz Van Haperen V et al (2003) Randomized phase II comparison of dose-intense gemcitabine: thirty-minute infusion and fixed dose rate infusion in patients with pancreatic adenocarcinoma. J Clin Oncol 21:3402–3408PubMedCrossRef Tempero M, Plunkett W, Ruiz Van Haperen V et al (2003) Randomized phase II comparison of dose-intense gemcitabine: thirty-minute infusion and fixed dose rate infusion in patients with pancreatic adenocarcinoma. J Clin Oncol 21:3402–3408PubMedCrossRef
15.
Zurück zum Zitat Mandola MV, Stoehlmacher J, Zhang W et al (2004) A 6 bp polymorphism in the thymidylate synthase gene causes message instability and is associated with decreased intratumoral TS mRNA levels. Pharmacogenetics 14:319–327PubMedCrossRef Mandola MV, Stoehlmacher J, Zhang W et al (2004) A 6 bp polymorphism in the thymidylate synthase gene causes message instability and is associated with decreased intratumoral TS mRNA levels. Pharmacogenetics 14:319–327PubMedCrossRef
16.
Zurück zum Zitat Lurje G, Zhang W, Yang D et al (2008) Thymidylate synthase haplotype is associated with tumor recurrence in stage II and stage III colon cancer. Pharmacogenet Genomics 18:161–168 Lurje G, Zhang W, Yang D et al (2008) Thymidylate synthase haplotype is associated with tumor recurrence in stage II and stage III colon cancer. Pharmacogenet Genomics 18:161–168
17.
Zurück zum Zitat Riechelmann RP, Townsley CA, Chin SN et al (2007) Expanded phase II trial of gemcitabine and capecitabine for advanced biliary cancer. Cancer 110:1307–1312PubMedCrossRef Riechelmann RP, Townsley CA, Chin SN et al (2007) Expanded phase II trial of gemcitabine and capecitabine for advanced biliary cancer. Cancer 110:1307–1312PubMedCrossRef
18.
Zurück zum Zitat Cho JY, Paik YH, Chang YS et al (2005) Capecitabine combined with gemcitabine (CapGem) as first-line treatment in patients with advanced/metastatic biliary tract carcinoma. Cancer 104:2753–2758PubMedCrossRef Cho JY, Paik YH, Chang YS et al (2005) Capecitabine combined with gemcitabine (CapGem) as first-line treatment in patients with advanced/metastatic biliary tract carcinoma. Cancer 104:2753–2758PubMedCrossRef
19.
Zurück zum Zitat Iyer RV, Gibbs J, Kuvshinoff B et al (2007) A phase II study of gemcitabine and capecitabine in advanced cholangiocarcinoma and carcinoma of the gallbladder: a single-institution prospective study. Ann Surg Oncol 14:3202–3209PubMedCrossRef Iyer RV, Gibbs J, Kuvshinoff B et al (2007) A phase II study of gemcitabine and capecitabine in advanced cholangiocarcinoma and carcinoma of the gallbladder: a single-institution prospective study. Ann Surg Oncol 14:3202–3209PubMedCrossRef
20.
Zurück zum Zitat Santini D, Vincenzi B, Vasile E et al (2009) Fixed dose rate (FDR) gemcitabine (G) and capecitabine (C) in patients with metastatic biliary tract cancer (BTC): final results of phase II trial. Abstract # e15510. Proceedings of the American Society of Clinical Oncology Santini D, Vincenzi B, Vasile E et al (2009) Fixed dose rate (FDR) gemcitabine (G) and capecitabine (C) in patients with metastatic biliary tract cancer (BTC): final results of phase II trial. Abstract # e15510. Proceedings of the American Society of Clinical Oncology
21.
Zurück zum Zitat Kim ST, Park JO, Lee J et al (2006) A phase II study of gemcitabine and cisplatin in advanced biliary tract cancer. Cancer 106:1339–1346PubMedCrossRef Kim ST, Park JO, Lee J et al (2006) A phase II study of gemcitabine and cisplatin in advanced biliary tract cancer. Cancer 106:1339–1346PubMedCrossRef
22.
Zurück zum Zitat Julka PK, Puri T, Rath GK (2006) A phase II study of gemcitabine and carboplatin combination chemotherapy in gallbladder carcinoma. Hepatobiliary Pancreat Dis Int 5:110–114PubMed Julka PK, Puri T, Rath GK (2006) A phase II study of gemcitabine and carboplatin combination chemotherapy in gallbladder carcinoma. Hepatobiliary Pancreat Dis Int 5:110–114PubMed
23.
Zurück zum Zitat André T, Reyes-Vidal JM, Fartoux L et al (2006) An international multicenter phase II trial of gemcitabine and oxaliplatin (GEMOX) in patients with advanced biliary tract cancer. J Clin Oncol. ASCO annual meeting proceedings part I, vol 24, no. 18S (June 20 Supplement), p 4135 André T, Reyes-Vidal JM, Fartoux L et al (2006) An international multicenter phase II trial of gemcitabine and oxaliplatin (GEMOX) in patients with advanced biliary tract cancer. J Clin Oncol. ASCO annual meeting proceedings part I, vol 24, no. 18S (June 20 Supplement), p 4135
Metadaten
Titel
A phase II trial of gemcitabine and capecitabine in patients with unresectable or metastatic gallbladder cancer or cholangiocarcinoma: Southwest Oncology Group study S0202
verfasst von
Syma Iqbal
Cathryn Rankin
Heinz-Josef Lenz
Philip J. Gold
Syed A. Ahmad
Anthony B. El-Khoueiry
Michael J. Messino
Randall F. Holcombe
Charles D. Blanke
Publikationsdatum
01.12.2011
Verlag
Springer-Verlag
Erschienen in
Cancer Chemotherapy and Pharmacology / Ausgabe 6/2011
Print ISSN: 0344-5704
Elektronische ISSN: 1432-0843
DOI
https://doi.org/10.1007/s00280-011-1657-1

Weitere Artikel der Ausgabe 6/2011

Cancer Chemotherapy and Pharmacology 6/2011 Zur Ausgabe

Adjuvante Immuntherapie verlängert Leben bei RCC

25.04.2024 Nierenkarzinom Nachrichten

Nun gibt es auch Resultate zum Gesamtüberleben: Eine adjuvante Pembrolizumab-Therapie konnte in einer Phase-3-Studie das Leben von Menschen mit Nierenzellkarzinom deutlich verlängern. Die Sterberate war im Vergleich zu Placebo um 38% geringer.

Alectinib verbessert krankheitsfreies Überleben bei ALK-positivem NSCLC

25.04.2024 NSCLC Nachrichten

Das Risiko für Rezidiv oder Tod von Patienten und Patientinnen mit reseziertem ALK-positivem NSCLC ist unter einer adjuvanten Therapie mit dem Tyrosinkinase-Inhibitor Alectinib signifikant geringer als unter platinbasierter Chemotherapie.

Bei Senioren mit Prostatakarzinom auf Anämie achten!

24.04.2024 DGIM 2024 Nachrichten

Patienten, die zur Behandlung ihres Prostatakarzinoms eine Androgendeprivationstherapie erhalten, entwickeln nicht selten eine Anämie. Wer ältere Patienten internistisch mitbetreut, sollte auf diese Nebenwirkung achten.

ICI-Therapie in der Schwangerschaft wird gut toleriert

Müssen sich Schwangere einer Krebstherapie unterziehen, rufen Immuncheckpointinhibitoren offenbar nicht mehr unerwünschte Wirkungen hervor als andere Mittel gegen Krebs.

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.