A trial of chemotherapy followed by chemoradiotherapy for locally advanced pancreatic cancer (SCALOP)

Cancer type:

Pancreatic cancer

Status:

Results

Phase:

Phase 2

This trial looked at GemCap chemotherapy, followed by radiotherapy with either gemcitabine or capecitabine for cancer of the pancreas that is locally advanced, but had not spread anywhere else in the body. This trial was supported by Cancer Research UK.

If pancreatic cancer can’t be removed with surgery, doctors may use a combination of chemotherapy and radiotherapy. This is called chemoradiotherapy or chemoradiation. The chemotherapy makes the cancer cells more sensitive to radiotherapy.

In this trial, researchers wanted to learn more about how well this treatment worked. Everybody taking part had chemotherapy to begin with. This was a combination of gemcitabine and capecitabine (GemCap). If the cancer didn’t get bigger, they then had chemoradiotherapy. At the same time as having radiotherapy, some people had gemcitabine and some capecitabine.

The aims of the trial were to

See if this treatment helped people with locally advanced pancreatic cancer
Learn more about the side effects
Find out if one chemotherapy drug worked better than the other when given at the same time as radiotherapy

Summary of results

The trial team found that, after initial chemotherapy, it might be better to use capecitabine rather than gemcitabine as part of chemoradiation for locally advanced pancreatic cancer.

This was a phase 2 trial. It was a randomised trial. People taking part were put into 1 of 2 treatment groups after their initial chemotherapy.

114 people agreed to take part in the trial. Everyone had 3 cycles of GemCap chemotherapy. Of these 114 people, 74 were able to have chemoradiation. Of these 74 people

38 had gemcitabine as part of their chemoradiation
36 had capecitabine as part of their chemoradiation

Overall people coped well with their treatment and most of them in both groups completed their radiotherapy.

A month after finishing radiotherapy, the researchers looked at how well people had responded to treatment. Of 35 people they looked at in the capecitabine group they found that

2 had no sign of their cancer – complete response
6 had cancer that had shrunk – partial response
22 had cancer that had stayed the same size – stable disease
5 had cancer that had started to grow again

Of the 36 people they looked at in the gemcitabine group they found that

7 had cancer that had shrunk
24 had cancer that had stayed the same
5 had cancer that had started to grow again

The average amount of time people lived and were free of cancer was

12 months for those in the capecitabine group
Just under 10½ months for those in the gemcitabine group

Overall the average amount of time that people lived was

Just over 17½ months for those who had capecitabine with radiotherapy
Just over 14½ months for those who had gemcitabine with their radiotherapy

The most common side effects reported were

The trial team concluded that although there were a small number of people in this trial the results suggest that capecitabine may be better than gemcitabine as a part of chemoradiation to treat locally advanced pancreatic cancer because it had a slightly better outcome and fewer side effects.

We have based this summary on information from the team who ran the trial. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item ) and published in a medical journal. The figures we quote above were provided by the trial team. We have not analysed the data ourselves.