Comparison of adjuvant gemcitabine and capecitabine with gemcitabine monotherapy in patients with resected pancreatic cancer (ESPAC-4): a multicentre, open-label, randomised, phase 3 trial

RCT (n=732) reported improved overall survival for patients in gemcitabine + capecitabine group (median 28 months vs. 25.5 months in gemcitabine group; HR 0.82; 95% CI, 0.68–0.98, p=0.032) and suggests this adjuvant combination should be new standard of care following resection.

According to a commentary, these results open the field to several questions:

 

• Can an increase in chemotherapy cure more patients in a cancer considered for more than 60 years to be chemoresistant?

• Do the figures from the ESPAC-4 trial at 5 years really represent patients cured of pancreatic cancer?

• How can survival of patients with pancreatic cancer be improved further?

• Do patients need to receive more surgery or more chemotherapy?