title: Gemcitabine plus capecitabine (Gem-Cape) biweekly in chemorefractory metastatic colorectal cancer.
abstract: OBJECTIVE
  A proportion of patients with metastatic colorectal cancer (mCRC) are still able to continue with active therapy after their progression to fluoropyrimidines, oxaliplatin, and irinotecan regimens. Studies suggest that gemcitabine and fluoropyrimidines are synergic antimetabolites. The purpose was to evaluate gemcitabine-capecitabine (Gem-Cape) in heavily pretreated mCRC and to thus assess possible predictive factors for progression-free survival (PFS) and overall survival (OS).
  
  
  METHODS
  This analysis was performed on 119 evaluable patients pretreated with fluoropyrimidines, oxaliplatin, irinotecan, and biological agents between June 2001 and July 2011. Patients received gemcitabine 1,000 mg/m(2) day 1 and capecitabine 1,000 mg/m(2) bid for 7 days every 2 weeks.
  
  
  RESULTS
  The general characteristics were ECOG 0-1, 89 %; male, 68 %, and median age 63 years. In total, 61 % had received two chemotherapy lines, while 39 % had received three or more. Objective response rates and stable disease rates at 3 months were 6.72 and 37.81 %, equalling a clinical benefit of 44.53 %. The median PFS and OS were 2.87 months [95 % confidence interval (CI) 2.53-3.17 months] and 6.53 months (95 % CI 5.33-8.77), respectively. The most frequent toxicities were grades 1-2, anemia (22 %), thrombocytopenia (10 %), and hand-foot syndrome (9 %); grade ≥3, diarrhea (2 %), with no treatment-related discontinuations. No treatment-related deaths were reported. Statistical significance was obtained by subgroups, assessing clinical benefits and objective responses for PFS and OS. Moreover, patients under 65 tended to have a better PFS.
  
  
  CONCLUSIONS
  These data suggest that Gem-Cape is a tolerable and feasible regimen, associated with clinical benefit in non-selected, heavily pretreated, mCRC patients.
authors.affiliation: Medical Oncology Department, Asturias Central University Hospital, Carretera de Rubín s/n Finca "La Cadellada", 33011, Oviedo, Asturias, Spain, palucaji@hotmail.com.
authors.forename: P
authors.initials: P
authors.lastname: Jiménez-Fonseca
authors.forename: M P
authors.initials: MP
authors.lastname: Solis
authors.forename: M
authors.initials: M
authors.lastname: Garrido
authors.forename: L
authors.initials: L
authors.lastname: Faez
authors.forename: D
authors.initials: D
authors.lastname: Rodriguez
authors.forename: A L
authors.initials: AL
authors.lastname: Ruiz
authors.forename: M L
authors.initials: ML
authors.lastname: Sanchez Lorenzo
authors.forename: E
authors.initials: E
authors.lastname: Uriol
authors.forename: M D
authors.initials: MD
authors.lastname: Menendez
authors.forename: J M
authors.initials: JM
authors.lastname: Viéitez
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000556:secondary; D000069287:Capecitabine / Q000008:administration & dosage; D003110:Colonic Neoplasms / Q000473:pathology*; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000556:secondary; D012004:Rectal Neoplasms / Q000473:pathology*; D019233:Retreatment; D012189:Retrospective Studies; D015996:Survival Rate; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D000069287:Capecitabine; D000093542:Gemcitabine