The ESPAC-4 trial changed the standard of care for resected pancreatic ductal adenocarcinoma. What adjuvant regimen did it establish?
- A Gemcitabine monotherapy for 6 months
- B Gemcitabine plus capecitabine for 6 months ✓
- C Modified FOLFIRINOX for 6 months
- D Gemcitabine plus erlotinib for 6 months
Explanation
The ESPAC-4 trial demonstrated that adjuvant gemcitabine plus capecitabine significantly improved median overall survival (28 months vs 25.5 months) compared to gemcitabine alone in resected pancreatic ductal adenocarcinoma. This combination became the preferred adjuvant regimen for most fit patients. Modified FOLFIRINOX has also shown superior results over gemcitabine alone (PRODIGE 24/CCTG PA.6 trial), particularly in patients with ECOG 0-1 performance status, and is now used for highly fit patients. Erlotinib added to gemcitabine did not show benefit in adjuvant pancreatic cancer.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.