718P - A three-step strategy of induction chemotherapy, chemo-radiotherapy and surgery in locally advanced pancreatic cancer (laPC). A single institutional...

Date 30 September 2012
Event ESMO Congress 2012
Session Poster presentation II
Topics Anti-Cancer Agents & Biologic Therapy
Pancreatic Cancer
Surgery and/or Radiotherapy of Cancer
Presenter Omar Esteban Carranza Rua
Authors O.E. Carranza Rua1, E. Arevalo2, J.P. Fusco1, E. Castanon Alvarez3, L. Zubiri1, J.A. Gonzalez4, L. Arbea5, F. Pardo6, S. Martin Algarra1, J. Rodriguez7
  • 1Medical Oncology, Clinica Universitaria de Navarra, 31008 - Pamplona/ES
  • 2Clinical Oncology, Clinica Universitaria de Navarra, 31008 - Pamplona/ES
  • 3Oncology Department, Clinica Universitaria de Navarra, 31008 - Pamplona/ES
  • 4Radiation Oncologist, clinica universidad de navarra, pamplona/ES
  • 5Radiation Oncology, clinica universidad de navarra, pamplona/ES
  • 6Surgical Oncologyst, clinica universidad de navarra, pamplona/ES
  • 7Medical Oncology, clinica universidad de navarra, pamplona/ES

Abstract

Background

Pancreatic cancer is one of the most highly fatal cancers. A growing evidence suggests that even potentially resectable patients (pts) benefit from a multidisciplinary approach aimed to improve resectability and reduce recurrence. We report our experience after a long-term follow-up.

Methods

From December 2005 to July 2011, 69 histologically confirmed LAPC, endoscopic ultrasound (EUS) staged T3/T4, N0/N1 were scheduled to receive induction gemcitabine-oxaliplatin-based chemotherapy followed by chemo-radiotherapy with weekly oxaliplatin and capecitabine (mean radiotherapy dose of 50.4 Gys) and salvage surgery when feasible. Adjuvant chemotherapy was considered depending on results of the pathologic report.

Results

The median age was 63 years (range 35-83 years). Male to female ratio was 37/32. Forty-one pts (59%) completed the whole program (group A), whereas 26 (37%) received chemo and chemo-radiotherapy but were not eligible for surgery (group B). Two patients (3%) progressed after induction chemotherapy (group C). Endoscopic stent placement was performed in thirty-four pts (49%). Toxicity profile was mild, with no grade 4 toxicity being documented. Grade 3 toxicity included: leucopenia (7%), neutropenia (11%), asthenia (13%) and nausea, diarrhea and anorexia (1% each). On an intent to treat basis, the R0 resection rate was 55% (38/69). Among resected patients, local and distant failure rates were 5 and 55% respectively. After a median follow up of 43 months (range 9 to 88), median PFS was 17, 9 and 1 month in groups A, B and C respectively. Median overall-survival (mOS) was 13 and 4 months in groups B and C. In group A mOS has not been reached. The 2 and 3-year actuarial overall survival in this group are 71% and 45% respectively.

Conclusions

Our data suggest that this three-step strategy is feasible and active in LAPC patients Correlative molecular analysis seem warranted to rule out the subset of pts most likely to benefit from this approach.

Disclosure

All authors have declared no conflicts of interest.