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Poster display session

2523 - Outcome of patients with pancreatic adenocarcinoma with complete pathological response following neo-adjuvant therapy

Date

09 Sep 2017

Session

Poster display session

Presenters

Hampig Raphael Kourie

Citation

Annals of Oncology (2017) 28 (suppl_5): v209-v268. 10.1093/annonc/mdx369

Authors

H.R. Kourie1, A. Sa Cunha2, S. Pernot1, R. Coriat3, A. Sauvanet4, N. Regenet5, S. Louafi6, J. Bachet7, D. Pietrasz7, J. Taieb1

Author affiliations

  • 1 Gastroenterology And Digestive Oncology, Hôpital européen Georges-Pompidou , Sorbonne Paris Cité Université Paris Descartes, 75015 - Paris/FR
  • 2 Centre Hépato-biliaire, Hôpital Paul Brousse, Unité d'Hospitalisation chirurgie hépatique, biliaire et pancréatique, Villejuif/FR
  • 3 Gastroenterology And Digestive Oncology, Hôpital Cochin, 75014 - PARIS/FR
  • 4 Hôpital Beaujon - Université Paris Vii, Service de Chirurgie Hépatobiliaire et Pancréatique - Department of HBP Surgery Pôle des Maladies de l'Appareil Digestif (PMAD), 92118 - Clichy/FR
  • 5 Service De Chirurgie Digestive Et Endocrinienne, CHU Nantes, Nantes - Nantes/FR
  • 6 Oncology, Centre Hospitalier de Longjumeau, 91161 - Longjumeau/FR
  • 7 Department Of Gastroenterology, CHU Pitié Salpetriere, 75651 - Paris/FR
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Resources

Abstract 2523

Background

Recently, the natural history of metastatic pancreatic adenocarcinoma (PC) has changed after the introduction of new chemotherapeutical regimens FOLFIRINOX and gemcitabine/nab-paclitaxel, with median overall survival exceeding the year. These regimens were also largely prescribed in the neo-adjuvant setting for locally advanced (LAPC) and borderline (BPC) PC leading sometimes to a complete pathological response (CPR) rarely seen with previous neoadjuvant regimens. The aim of this study was to assess outcomes of patients (pts) who presented CPR after induction therapy for PC.

Methods

We retrospectively identified pts with PC presenting CPR after neo-adjuvant therapy in 7 participating French centers from the AGEO group between November 2010 and March 2017.

Results

26 pts were enrolled, 12 had LAPC, 13 BPC and 1 oligo-metastatic PC; M/F ratio was 1.6 and mean age was 61 years. All pts were treated with neo-adjuvant FOLFIRINOX (n = 26), de-escalated to gemcitabine (n = 1) and FOLFIRI (n = 2). The median number of cycles was 6 [4-24] and 85% of pts received neo-adjuvant radiation therapy after chemotherapy. Response to neo-adjuvant chemotherapy (RECIST V1.1), was as follow: CR 8% PR 57%, SD 27% and 8% were not evaluated. 30% of pts received adjuvant chemotherapy mainly with gemcitabine and 9 (35%) relapsed (distant metastases, n = 8). Median time to recurrence in pts that replapsed was 12.9 months. After a median follow-up of 29.5 months, the median overall survival (OS) from surgery was not reached and the median disease free survival was 38.8 months. The 1-year and 2-year OS rates were respectively 100% and 94%. The 1-year and 2-year DFS rates were 86% and 70%.

Conclusions

CPR seem to be an important prognostic marker in pts resected of a PC after neo-adjuvant therapy. The limited recurrences rate and the 1 and 2-year OS and DFS rates are very promising. A longer follow-up and prospective series are now necessary to confirm the favorable outcomes of these PC with CPR.

Clinical trial identification

Legal entity responsible for the study

AGEO French Study Group

Funding

None

Disclosure

S. Pernot: Honorarium and congress fees from Merck, Amgen, Sanofi. A. Sauvanet: Financial support for participation to scientific meetings: Eumedica Fees/honorarium for preparation and performance of lectures: Novartis. J-B. Bachet: Fees: Amgen, Bayer, Celgène, Merck Serono, Sanofi. Consultant: Amgen, Bayer, Merck Serono, Servier. J. Taieb: Consulting and/or advisory boards for Merck KGaA, Sanofi, Roche Genentech, Pfizer and Amgen. All other authors have declared no conflicts of interest.

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