Robert L. Fine, MD, an associate professor of Medicine at New York Presbyterian Hospital-Columbia University Medical Center, discusses a phase II study that evaluated the efficacy of neoadjuvant gemcitabine, docetaxel, and capecitabine (GTX) in patients with inoperable pancreatic adenocarcinoma.

The GTX regimen, a combination of low-dose gemcitabine, docetaxel, and capecitabine, is synergistic and induces apoptosis in pancreatic cancer, Fine says. GTX is a much less toxic regimen compared to FOLFIRINOX, though it produces similar outcomes. However, GTX is still not accepted as an alternative to FOLFIRINOX. 

In the phase II study, GTX has a response rate and a stable disease rate of 38% , a clinical benefit rate of 76%, a progression-free survival of 6.9 months, and an overall survival of 14.7 months. Fine says the overall survival that was produced by GTX in this study is the longest reported by any institution for pancreatic cancer. 

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Robert L. Fine, MD, an associate professor of Medicine at New York Presbyterian Hospital-Columbia University Medical Center, discusses a phase II study that evaluated the efficacy of neoadjuvant gemcitabine, docetaxel, and capecitabine (GTX) in patients with inoperable pancreatic adenocarcinoma

Dr. Fine on GTX in Inoperable Pancreatic Cancer

Robert L. Fine, MD, an associate professor of Medicine at New York Presbyterian Hospital-Columbia University Medical Center, discusses the prospective phase II study of CAPTEM (capecitabine and temozolomide) for patients with neuroendocrine tumors.

Fine says the results of the trial showed tremendous responses in every neuroendocrine tumor. The treatment elicited a response rate of 45% and a stable disease rate of 52%.

Carcinoids, which represents that majority of all neuroendocrine tumors and normally have a response rate of 0%-4%, showed a 45% response rate in this study, Fine says.

Moreover, Fine points out, the CAPTEM combination is extremely nontoxic. There were no grade 4 toxicities and only 10-15% grade 3 toxicities, with the most common grade 3 toxicity being lymphopenia.

View more from the 2014 GI Cancers Symposium

Robert L. Fine, MD, from the Columbia University Medical Center, discusses the prospective phase II study of CAPTEM for patients with neuroendocrine tumors.

Robert L. Fine, MD

Articles

Dr. Fine on GTX in Inoperable Pancreatic Cancer

Dr. Fine on Capecitabine Plus Temozolomide for NETs