Evaluating the toxicity of capecitabine-cisplatin versus gemcitabine-cisplatin regimens for palliative chemotherapy in advanced biliary tract carcinoma
DOI:
https://doi.org/10.18203/2320-6012.ijrms20240512Keywords:
Carcinoma, Biliary, Gemcitabine, Capecitabine, Cisplatin, EfficacyAbstract
Background: Advanced biliary tract carcinoma is a malignancy associated with poor prognosis and limited treatment options. This study aimed to compare the treatment effects in terms of toxicities of Capecitabine-Cisplatin and Gemcitabine-Cisplatin regimens as palliative chemotherapy for ABTC in Bangladesh.
Methods: This quasi-experimental study was conducted at the Department of Oncology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, involving 78 patients with histopathologically confirmed ABTC (AJCC Stage IV). Participants were divided into two groups: Arm-A received Capecitabine-Cisplatin, and Arm-B received Gemcitabine-Cisplatin. Treatment response, hematological and non-hematological toxicities were assessed and compared between the two groups.
Results: No significant differences in baseline demographic and clinical characteristics were observed between the two groups. Arm-A demonstrated a higher rate of partial response in the final assessment (51.28% vs. 41.03%, p=0.029). Acute hematological toxicities were more frequent in Arm-B, with a higher incidence of Grade 2 and 3 anemia, neutropenia, and leukopenia (p<0.05). Non-hematological toxicities were comparable, except for Hand-Foot Syndrome, which was significantly higher in Arm-A (p=0.03).
Conclusions: The Capecitabine-Cisplatin regimen exhibited a different toxicity profile compared to the Gemcitabine-Cisplatin regimen for palliative chemotherapy in advanced biliary tract carcinoma. While both regimens were generally well-tolerated, the Capecitabine-Cisplatin regimen demonstrated lower incidences of hematological toxicities. These findings emphasize the importance of considering toxicity profiles when selecting treatment options for patients with advanced biliary tract carcinoma.
References
Rizvi S, Khan SA, Hallemeier CL, Kelley RK, Gores GJ. Cholangiocarcinoma evolving concepts and therapeutic strategies. Nat Rev Clin Oncol. 2018; 15(2):95-111.
Bertuccio P, Malvezzi M, Carioli G, Hashim D, Boffetta P, El-Serag HB, et al. Global trends in mortality from intrahepatic and extrahepatic cholangiocarcinoma. J Hepatol. 2019;71(1):104-14.
Cancer today. Available at: http://gco.iarc.fr/today/ home. Accessed on 20 November 2023.
Banales JM, Marin JJG, Lamarca A, Rodrigues PM, Khan SA, Roberts LR, et al. Cholangiocarcinoma 2020: the next horizon in mechanisms and management. Nat Rev Gastroenterol Hepatol. 2020; 17(9):557-88.
Valle J, Wasan H, Palmer DH, Cunningham D, Anthoney A, Maraveyas A, et al. Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer. N Engl J Med. 2010;362(14):1273-81.
Park BK, Kim YJ, Park JY, Bang S, Park SW, Chung JB, et al. Phase II study of gemcitabine and cisplatin in advanced biliary tract cancer. J Gastroenterol Hepatol. 2006;21(6):999-1003.
Lee J, Park SH, Chang HM, Kim JS, Choi HJ, Lee MA, et al. Gemcitabine and oxaliplatin with or without erlotinib in advanced biliary-tract cancer: a multicentre, open-label, randomised, phase 3 study. Lancet Oncol. 2012;13(2):181-8.
Walko CM, Lindley C. Capecitabine: a review. Clin Ther. 2005;27(1):23-44.
Hoff PM, Ansari R, Batist G, Cox J, Kocha W, Kuperminc M, et al. Comparison of oral capecitabine versus intravenous fluorouracil plus leucovorin as first-line treatment in 605 patients with metastatic colorectal cancer: results of a randomized phase III study. J Clin Oncol. 2001;19(8):2282-92.
Stinton LM, Shaffer EA. Epidemiology of gallbladder disease: cholelithiasis and cancer. Gut Liver. 2012; 6(2):172-87.
Okusaka T, Nakachi K, Fukutomi A, Mizuno N, Ohkawa S, Funakoshi A, et al. Gemcitabine alone or in combination with cisplatin in patients with biliary tract cancer: a comparative multicentre study in Japan. Br J Cancer. 2010;103(4):469-74.
Saif MW, Choma A, Salamone SJ, Chu E. Pharmacokinetically guided dose adjustment of 5-fluorouracil: a rational approach to improving therapeutic outcomes. J Natl Cancer Inst. 2009; 101(22):1543-52.
Lee J, Hong TH, Lee IS, You YK, Lee MA. Comparison of the Efficacy between Gemcitabine-Cisplatin and Capecitabine-Cisplatin Combination Chemotherapy for Advanced Biliary Tract Cancer. Cancer Res Treat. 2015;47(2):259-65.
