title: Comparison of the Efficacy between Gemcitabine-Cisplatin and Capecitabine-Cisplatin Combination Chemotherapy for Advanced Biliary Tract Cancer.
abstract: OBJECTIVE
  Gemcitabine-cisplatin combination chemotherapy has been regarded as standard regimen for advanced or metastatic biliary tract cancer (BTC), based on the ABC-02 trial. To date, however, no studies have compared the efficacies of gemcitabine-platinum and fluoropyrimidine- platinum combination chemotherapy, even though fluoropyrimidine has been widely used as a backbone agent for gastrointestinal cancer. This study compared the efficacy and toxicities of gemcitabine-cisplatin (GP) and capecitabine-cisplatin (XP) combination chemotherapy for treatment of advanced BTC.
  
  
  METHODS
  We examined 49 patients treated with GP and 44 patients treated with XP from October 2009 to July 2012. All patients had unresectable BTC. The GP regimen comprised gemcitabine (1,000 mg/m(2), intravenously [IV], days 1 and 8) and cisplatin (75 mg/m(2), IV, day 1). The XP regimen comprised capecitabine (1,250 mg/m(2) twice a day, peroral, days 1-14) and cisplatin (60 mg/m(2), IV, day 1, every three weeks). We analyzed the response rate (RR), time to progression (TTP), overall survival (OS), and toxicity.
  
  
  RESULTS
  The RRs were 27.3% and 6.1% in the XP and GP arms, respectively. XP resulted in longer TTP (5.2 months vs. 3.6 months, p=0.016), but OS was not statistically different (10.7 months vs. 8.6 months, p=0.365). Both regimens resulted in grade 3-4 hematologic toxicities, but febrile neutropenia was not noted. Grade 3-4 asthenia, stomatitis, and hand-foot syndrome occurred more frequently in the XP arm.
  
  
  CONCLUSIONS
  XP resulted in a superior TTP and RR compared to GP for treatment of advanced BTC, with comparable toxicity. Conduct of prospective large, randomized trials to evaluate the possibility of XP as another standard therapy is warranted.
authors: Department of Internal Medicine Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
authors: Jieun
authors: J
authors: Lee
authors: Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea ; Department of Hepato-Biliary-Pancreatic Cancer Center, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
authors: Tae Ho
authors: TH
authors: Hong
authors: Department of Internal Medicine Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea ; Department of Hepato-Biliary-Pancreatic Cancer Center, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
authors: In Seok
authors: IS
authors: Lee
authors: Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea ; Department of Hepato-Biliary-Pancreatic Cancer Center, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
authors: Young Kyoung
authors: YK
authors: You
authors: Department of Internal Medicine Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea ; Department of Hepato-Biliary-Pancreatic Cancer Center, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea ; Cancer Research Institute, The Catholic University of Korea College of Medicine, Seoul, Korea.
authors: Myung Ah
authors: MA
authors: Lee
keywords: Biliary tract neoplasms; Capecitabine; Cisplatin; Gemcitabine
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