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Poster Display

3173 - Intensified chemotherapy for metastatic pancreatic cancer: interim analysis of a large retrospective pan-European database and real life evaluation


08 Oct 2016


Poster Display


Sebastian Krug


Annals of Oncology (2016) 27 (6): 207-242. 10.1093/annonc/mdw371


S. Krug1, G. Beyer2, M.A. Javed3, N. Le4, A. Vinci5, R.D. Morgan6, R. Hubner6, J.W. Valle7, H. Wong8, S. Chowdhury9, Y. Ting Ma9, D. Palmer10, P. Maisonneuve11, A. Neesse12, M. Sund13, M. Schober1

Author affiliations

  • 1 Department Of Internal Medicine I, Martin Luther University of Halle, 06120 - Halle/DE
  • 2 Department Of Medicine A, University Medicine Greifswald, Greifswald/DE
  • 3 Nihr Liverpool Pancreas Biomedical Research Unit, Institute Of Translational Medicine, Royal Liverpool University Hospital, Liverpool/GB
  • 4 Gastroenterology Division, Semmelweis University, 2nd Dept. of Internal Medicine, Budapest/HU
  • 5 Department Of Surgery, University of Pavia, Matteo University Hospital Foundation, Pavia/IT
  • 6 Department Of Medical Oncology, The Christie NHS Foundation Trust, Manchester/GB
  • 7 Department Of Medical Oncology, Enets Centre Of Excellence; Manchester Academic Health Sciences Centre, Institute Of Cancer Sciences, University Of Manchester, The Christie NHS Foundation Trust, M20 4BX - Manchester/GB
  • 8 Department Of Quality And Information Intelligence, Clatterbridge Cancer Center, Wirral/GB
  • 9 Department Of Hepatobiliary Oncology, Queen Elizabeth-University Hospital Birmingham NHS Foundation Trust, Birmingham/GB
  • 10 Molecular And Clinical Cancer Medicine, University of Liverpool, Liverpool/GB
  • 11 Division Of Epidemiology And Biostatistics, European Institute of Oncology, Milano/IT
  • 12 Department Of Gastroenterology And Gastrointestinal Oncology, University Medical Center Göttingen, Göttingen/DE
  • 13 Department Of Surgical And Perioperative Sciences, Umea University, Umea/SE


Abstract 3173


For a long time gemcitabine (gem) has been the standard of care for patients with pancreatic ductal adenocarcinoma (PDAC). Recently, FOLFIRINOX and nab-paclitaxel/gemcitabine (nab-P/gem) were introduced showing significantly improved survival in clinical trials. This study aims to investigate the efficacy and tolerability of FOLFIRINOX and nab-P/gem versus gem monotherapy in real-life settings across different European institutions and to analyze the decision-making process among physicians administering these drugs.


634 patients from 8 centers with PDAC receiving palliative chemotherapy between 2012 and 2015 were included in a retrospective multinational study design. In an independent survey, a web-based questionnaire containing 15 questions regarding the use of different chemotherapy options in metastatic PDAC was distributed among 5420 doctors in 19 European countries.


Of the 634 included patients, 351 (55%) were male and 97 (15%) had been surgically resected before systemic recurrence. Gem treatment (monotherapy + /-capecitabine/cisplatin) was the regimen most commonly used in European centers (74%) as compared to FOLFIRINOX (9%) and nab-P/gem (3%). The median overall survival in different groups were: FOLFIRINOX 12.0m (95%CI8.5-15.5), nab-P/gem 7.0m (95%CI4.7-9.3) and gem monotherapy 5.0m (95%CI4.4-5.6). Only FOLFIRINOX was associated with improved survival as compared to gem monotherapy (p 


Our retrospective cohort showed that gem therapy was still predominantly used. However, the pan-European questionnaire revealed a more frequent use of intensified regimens indicating an increasing acceptance among European physicians in 2015. Intensified regimens are widely available throughout Europe, but used variably in clinical routine dependent on hospital setting and country.

Clinical trial identification

Legal entity responsible for the study



Pancreas2000, an educational and research program for tomorrows pancreatologists in Europe.


All authors have declared no conflicts of interest.

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