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How do you approach adjuvant chemotherapy in patients with resected pancreatic adenocarcinoma?

In light of the results of the ESPAC-4 trial, is the combination of gemcitabine plus capecitabine being considered over single-agent gemcitabine for adjuvant therapy?
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In fit patients with resected pancreatic adenocarcinoma, what is your preferred adjuvant regimen?

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3 Answers
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Medical Oncology · Stanford University School of Medicine
Answered on

For my good performance status patients, I offer gem/cap as per the ESPAC-4 trial. Though the incremental benefit is modest, it was statistically significant and the toxicities associated with the combination are quite manageable most of the time. I look forward to the results of three other adjuvan...

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Medical Oncology · Memorial Sloan Kettering Cancer Center
Answered on

For resected pancreas cancer - the ESPAC-4 data for gemcitabine/capecitabine support the use of this regimen and outside of a trial setting, this combination represents a new standard option for this disease. We now routinely use this regimen in practice. Nonetheless given pending data on other mult...

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Medical Oncology · Mayo Clinic
Answered on

The main take away from PRODIGE24 further support the role for adjuvant chemotherapy with an added benefit for FOLFIRINOX. For good performance status patients, I would recommend FOLFIRINOX chemotherapy, which showed a significant improvement in disease free survival and overall survival compared to...

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