P-176 - Nabpaclitaxel plus gemcitabine as induction chemotherapy (CT) followed by chemoradiation (CRT) in locally advanced pancreatic cancer (LAPC)

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Anti-Cancer Agents & Biologic Therapy
Pancreatic Cancer
Surgery and/or Radiotherapy of Cancer
Presenter L. Foltran
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors L. Foltran1, G. Boz2, G. Lo Re1, R. Innocente2, D. Tonin1, A. De Paoli3, G. Tosolini1, A. Del Conte1, S. Saracchini1, P. Sandri1
  • 1General Hospital “S. Maria degli Angeli”, Pordenone/IT
  • 2National Cancer Institute CRO, Aviano/IT
  • 3Centro di Riferimento Oncologico, Aviano/IT

Abstract

Introduction

Survival of LAPC remains poor (9-13 months). Large phase III randomized trials are lacking in neoadjuvant setting for LAPC. Neoadjuvant treatment aims to increase local tumour response, improve systemic disease control and possibly achieve tumour resection. Therefore, induction CT with nabpaclitaxel and gemcitabine followed by CRT may improve outcome in LAPC.

Methods

We retrospectively reviewed 6 LAPC patients (pts) who received induction CT with gemcitabine plus nabpaclitaxel for 3 cycles and subsequent CRT (54 Gy with gemcitabine 600 mg/mq weekly for 6 weeks“ -> substitute with”…gemcitabine 40 mg/mq twice a week for 5 weeks). Clinical data and outcomes were explored.

Results

Characteristics of pts are reported in the Table. Treatment was active: 4 PR, 1 SD, 1 PD. One patient progressed after 2 cycles of induction CT, the others completed the planned neoadjuvant treatment. Median progression free survival (PFS) was 9.8 months. The most frequent not severe adverse events were: fatigue, anorexia, neutropenia and nausea.

To be noted that tumour was resected in one case; radiofrequency ablation and intra-arterial chemotherapy were applied in two cases.

Conclusion

Nabpaclitaxel plus gemcitabine for 3 cycles followed by CRT achieves high disease control rate. This strategy may select no rapidly progressive LAPC that could be re-evaluated for resection or locoregional therapies. Treatment is feasible, well tolerated and worthy of further investigation in prospective trials.

Table: P-176