680P - Chemotherapy for patients with non-resectable pancreatic cancer with additional chemo-radiotherapy for patients with potentially resectable tumours...

Date 08 October 2016
Event ESMO 2016 Congress
Session Poster Display
Topics Pancreatic Cancer
Surgical oncology
Therapy
Radiation oncology
Presenter Per Pfeiffer
Citation Annals of Oncology (2016) 27 (6): 207-242. 10.1093/annonc/mdw371
Authors P. Pfeiffer1, M. Ladekarl2, M.B. Mortensen3, A. Fromm4, J.K. Bjerregaard1
  • 1Department Of Oncology, Odense University Hospital, 5000 - Odense C/DK
  • 2Department Of Oncology, Aarhus University Hospital, 8800 - Aarhus C/DK
  • 3Department Of Surgery, Odense University Hospital, 5000 - Odense C/DK
  • 4Department Of Oncology, University Hospital Herlev, 2730 - Herlev/DK

Abstract

Background

Locally advanced pancreatic cancer (LAPC) is often a mix of borderline and never-resectable tumors. Multimodality treatment might downstage these tumors to allow a potential radical resection, especially the borderline group. In this ongoing phase II study we examined the feasibility of FOLFIRINOX with or without CRT followed by surgery for both borderline and never-resectable tumors (NCT-01397019).

Methods

Patients in performance status 0-1, with initially non-resectable stage II/III pancreatic cancer were offered FOLFIRINOX (oxaliplatin 85 mg/m2, irinotecan 180 mg/m2, leucovorin 400 mg/m2, 5FU 400 mg/m2+ 2400 mg/m2) every 14 days. Every 4th series the patients were evaluated and offered CRT (50.4 Gy/27F & capecitabine) if deemed potentially resectable. Resections were performed if deemed possible by the MDT.

Results

Between August 2012 and present, 59 patients have been recruited with a median observation time of 17.4 months. Median age was 65(range 38-75) years, with 40%/60% stage II/III distribution. Median CA19-9 was 268(range 1-13,432). Three-hundred-sixty-two courses of FOLFIRINOX have been given, with a median of 6.0 per patient, with a median of 2 without dose modifications. Presently twenty-two patients have been treated with CRT. Six-teen patients have been resected, of which 8 received prior CRT. Median survival for all patients was 21.1 months (14-NR) with a 1-year survival of 74% (58-85). For patients not resected the median survival was 14.1 months (10-16) for resected the median survival has not yet been reached. The FOLFIRINOX was associated with adverse events similar to what is expected in metastatic patients.

Conclusions

FOLFIRINOX with or without CRT in patients with LAPC shows promising efficacy in patients with both borderline and never-resectable tumors. Unmodified FOLFIRINOX had acceptable toxicity, however dose reductions are often needed. CRT following initial FOLFIRINOX was feasible and without unexpected toxicity.

Clinical trial identification

NCT-01397019

Legal entity responsible for the study

N/A

Funding

Danish Pancreatic Cancer Group

Disclosure

All authors have declared no conflicts of interest.