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Survival remains poor after resection of pancreatic adenocarcinoma. Adjuvant chemotherapy with either gemcitabine monotherapy or 5-fluorouracil plus leucovorin has been shown to improve survival and is standard treatment after surgery.
Now, investigators have conducted an international, multicenter, open-label, randomized phase III trial (ESPAC-4) to determine the efficacy and safety of adding capecitabine to gemcitabine in 730 patients undergoing complete pancreatic cancer resection. Patients were treated with weekly gemcitabine (3 weeks on and 1 week off for 6 months) with or without the addition of capecitabine (1600 mg/m2 daily for 21 days followed by 7 days of rest). Most patients had lymph-node–positive disease (79%–82%), stage III dis…