title: A novel schedule of erlotinib/capecitabine (7/7) as salvage therapy in previously treated advanced pancreatic adenocarcinoma: a case series.
abstract: BACKGROUND
  The objective of this study was to report a case series on the efficacy and safety of capecitabine 7/7 schedule combined with erlotinib (CAP-ERL) in patients with advanced pancreatic cancer (APC) who have failed prior therapies.
  
  
  METHODS
  We retrospectively evaluated 13 patients with locally advanced or metastatic pancreatic cancer previously treated with gemcitabine or oxaliplatin-irinotecan-based first-line regimens. Treatment consisted of capecitabine (Xeloda) at a flat dose of 1000 mg orally twice daily on days 1-7 out of 14 days (7/7 schedule) and erlotinib (Tarceva) 100 mg orally once daily until unacceptable toxicity or disease progression. Tumor assessments were repeated every two cycles (8 weeks) and serum tumor markers were measured every 4 weeks.
  
  
  RESULTS
  All patients (median age: 63 years; 7 female/3 male) had various previous lines of treatments of chemotherapies. Median number of cycles with CAP-ERL was 4 (range 2-12). The overall response rate was 20%. CA19-9 was reduced more than 25% in 40% patients. The median overall survival and progression-free survival from the start of CAP-ERL were 4.5 months (range 3-7.5) and 2 months (range 1.5-4), respectively. The most common grade 3 toxicities included hand-foot syndrome, nausea, vomiting, diarrhea, rash, and fatigue.
  
  
  CONCLUSIONS
  Our result suggests that the combination of a fixed low dose of CAP-ERL 7/7 schedule was tolerated with manageable toxicity and showed encouraging activity as salvage treatment in patients with refractory APC with ECOG performance status 0-2. Further prospective studies are warranted to evaluate this combination.
authors.affiliation: School of Biomedical Sciences and Australian Institute of Bioengineering and Nanotechnology, University of Queensland, QLD, Australia.
authors.forename: Jiezhong
authors.initials: J
authors.lastname: Chen
authors.affiliation: School of Medicine, New Haven, CT, USA.
authors.forename: Kristin
authors.initials: K
authors.lastname: Kaley
authors.affiliation: Columbia University Medical Center, New York, NY, USA.
authors.forename: Marie Carmel
authors.initials: MC
authors.lastname: Garcon
authors.affiliation: Columbia University Medical Center, New York, NY, USA.
authors.forename: Teresa
authors.initials: T
authors.lastname: Rodriguez
authors.affiliation: Section of GI Cancers and Experimental Therapeutics, Tufts University School of Medicine and Tufts Cancer Center, 800 Washington Street, Boston, MA 02111, USA.
authors.forename: Muhammad Wasif
authors.initials: MW
authors.lastname: Saif
keywords: capecitabine; erlotinib; gemcitabine; pancreas; pancreatic neoplasm; rash