Research chemicals library of targeted agents with cytotoxic drugs or with other novel anticancer drugs. In our study, the combination of FDR gemcitabine and capecitabine demonstrated an interesting activity and a favorable safety in patients with advanced and/or metastatic BTC. Despite the usual limitation of cross study comparisons, these findings compare favorably with results previously reported for 5 FU/gemcitabine combinations in patients with advanced BTC. In addition to antitumor activity, safety is a critically important target for the choice of new treatment combinations. Our combination regimen has the advantage of convenience and practicability over continuous intravenous 5 FU plus either gemcitabine or cisplatin, and has a clear potential to reduce taurine healthcare resource expenditure. This is because capecitabine is administered orally and avoids the complications related to the use of an implanted catheter required for the continuous intravenous administration of 5 FU.
In our experience, the toxicity profile is acceptable especially when compared with the toxicities reported in comparable studies. Grade 3 neutropenia and asthenia were reported in 10 and 16%, respectively, and these data are superimposed with the data reported in the literature. Sirolimus biliary tumors can occur anywhere in the hepatobiliary system and are often classified according to location. In the present study, cholangiocarcinoma appeared to respond better than gallbladder carcinoma, obtaining a major OS, even if the interpretation of data is difficult because of the relatively small number of patients and the different biological and prognostic behavior of the single isotypes. Conclusions Further research in this area should be directed at finding the best cytotoxic agent for a combination with capecitabine or gemcitabine or altering the dose intensity or route of administration in advanced BTC. Conventional Rhein chemotherapeutic drugs have achieved only modest results in patients with BTC.
Therefore, innovative therapeutic approaches are needed to obtain significant results in this type of patients. The first standard of care has been proposed at ASCO 2009. In fact, the combination of cisplatin and gemcitabine has been shown to be more effective than gemcitabine alone in a multicenter randomized phase III trial, and new phase III trials evaluating a different combination of chemotherapy are needed. Due to the small number of patients and the inclusion of all biliary types in this study, these results cannot be translated in clinical practice. A larger randomized phase III trial of our combination regimen compared with gemcitabine plus cisplatin needs to be conducted to validate the efficacy of FDR gemcitabine plus capecitabine in metastatic/advanced BTC patients. Several trials are ongoing with the aim to explore the activity of the combination of chemotherapeutics with different targeted drugs inhibiting different pathways. The results of the ongoing trials are keenly awaited to definitely identify the most effective strategy in BTC.Colorectal cancer is the second leading cause of death related to cancer in North America and Europe. Historically, 5 Xuorouracil with leucovorin was the only systemic treatment option for metastatic colorectal cancer. More recently, there have been signiWcant advanc.