Abstract 1169
Background
Locally advanced pancreatic cancer (LAPC) represents more than one third of pancreatic cancers and owns poor survival after the standard chemotherapy. Irreversible electroporation (IRE) is a novel method and has been recently used in LAPC. The aim of this study was to compare the efficacy of IRE combined with chemotherapy and chemotheraoy alone for patients with LAPC.
Methods
Locally advanced pancreatic cancer (LAPC) represents more than one third of pancreatic cancers and owns poor survival after the standard chemotherapy. Irreversible electroporation (IRE) is a novel method and has been recently used in LAPC. The aim of this study was to compare the efficacy of IRE combined with chemotherapy and chemotheraoy alone for patients with LAPC.
Results
Before PSM analysis, patients with LAPC had better overall survival (OS), cancer-specific survival (CSS) and progression-free survival (PFS) after IRE combined with chemotherapy compared with chemotherapy alone (median OS, 16.0 months vs 8.0 months in SEER dataset, P < 0.001, 21.6 months vs 7.1 months in SYSUCC dataset, P = 0.006; median CSS, 18 months vs 8 months, P < 0.001; median PFS, 7.7 months vs 4.9 months, P = 0.001). Multivariate Cox regression analysis indicated that IRE combined with chemotherapy was identified as a significant prognostic factor for OS, CSS and PFS in LAPC patients of both the whole cohort and the matched cohort.Table: 703P
Univariate and multivariate analyses of OS in patients
Characteristic | Before PSM | After PSM | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Univariate analysis | Multivariate analysis | Univariate analysis | Multivariate analysis | ||||||||||
HR | 95%CI | P | HR | 95%CI | P | HR | 95%CI | P | HR | 95% CI | P | ||
SEER dataset | |||||||||||||
Age (years) | ≤ 60 / > 60 | 1.295 | 1.193-1.406 | <0.001 | 1.281 | 1.180-1.391 | <0.001 | 1.304 | 1.186-1.435 | <0.001 | 1.283 | 1.166-1.412 | <0.001 |
Gender | Female / Male | 0.999 | 0.928-1.075 | 0.984 | NI | 0.994 | 0.914-1.082 | 0.895 | NI | ||||
Race | Black / White / Others | 0.949 | 0.876-1.027 | 0.194 | NI | 0.937 | 0.855-1.026 | 0.159 | |||||
Tumor size (cm) | ≤ 2 / 2∼4 / >4 | 1.137 | 1.066-1.213 | <0.001 | 1.148 | 1.075-1.225 | <0.001 | 1.135 | 1.054-1.222 | 0.001 | 1.138 | 1.056-1.226 | 0.001 |
Tumor grade | Well / Moderate / Poor | 1.115 | 1.048-1.186 | 0.001 | 1.077 | 1.012-1.147 | 0.019 | 1.119 | 1.043-1.200 | 0.002 | 1.081 | 1.007-1.160 | 0.032 |
LN metastasis | Absent / Present | 1.076 | 0.996-1.162 | 0.064 | NI | 1.072 | 0.981-1.172 | 0.123 | NI | ||||
Tumor site | Head / Body / Tail | 0.956 | 0.909-1.006 | 0.082 | NI | 0.960 | 0.960-1.016 | 0.157 | NI | ||||
Radiotherapy | No / Yes | 0.640 | 0.592-0.691 | <0.001 | 0.610 | 0.565-0.660 | <0.001 | 0.630 | 0.572-0.694 | <0.001 | 0.608 | 0.552-0.671 | <0.001 |
Chemotherapy | Without IRE / With IRE | 0.428 | 0.351-0.522 | <0.001 | 0.369 | 0.302-0.451 | <0.001 | 0.403 | 0.329-0.492 | <0.001 | 0.370 | 0.302-0.453 | <0.001 |
SYSUCC dataset | |||||||||||||
Age (years) | ≤ 60 / > 60 | 1.154 | 0.600-2.222 | 0.668 | NI | 0.889 | 0.351-0.253 | 0.804 | NI | ||||
Gender | Female / Male | 2.399 | 1.077-5.343 | 0.052 | NI | 4.630 | 1.317-16.275 | 0.017 | 4.975 | 1.081-22.891 | 0.039 | ||
Tumor size (cm) | ≤ 2 / 2∼4 / >4 | 1.657 | 0.843-3.257 | 0.143 | NI | 2.863 | 1.021-8.033 | 0.046 | 2.012 | 0.764-5.294 | 0.157 | ||
Tumor grade | Well / Moderate / Poor | 1.182 | 0.669-2.086 | 0.565 | NI | 1.797 | 0.680-3.293 | 0.316 | NI | ||||
LN metastasis | Absent / Present | 7.966 | 3.285-19.315 | <0.001 | 4.091 | 1.484-11.278 | 0.006 | 7.264 | 2.220-23.775 | 0.001 | 4.799 | 1.173-19.625 | 0.029 |
Tumor site | Head / Body / Tail | 1.317 | 0.879-1.973 | 0.182 | NI | 1.310 | 0.700-2.452 | 0.398 | NI | ||||
WBC (*109) | ≤ 10 / > 10 | 1.058 | 0.371-3.019 | 0.916 | NI | 0.463 | 0.061-3.527 | 0.457 | NI | ||||
HGB (g/L) | ≤ 120 / > 120 | 0.852 | 0.419-1.733 | 0.659 | NI | 1.401 | 0.461-4.264 | 0.552 | NI | ||||
PLT (*109) | ≤ 300 / > 300 | 0.513 | 0.181-1.455 | 0.209 | NI | 0.484 | 0.110-2.126 | 0.337 | NI | ||||
ALT (U/L) | ≤ 40 / > 40 | 0.929 | 0.435-1.981 | 0.848 | NI | 1.034 | 0.365-2.929 | 0.950 | NI | ||||
AST (U/L) | ≤ 40 / > 40 | 1.006 | 0.417-2.428 | 0.989 | NI | 0.623 | 0.143-2.719 | 0.529 | NI | ||||
ALP (U/L) | ≤ 100 / > 100 | 1.686 | 0.867-3.277 | 0.124 | NI | 1.395 | 0.549-3.546 | 0.484 | NI | ||||
GGT (U/L) | ≤ 45 / > 45 | 1.646 | 0.840-3.224 | 0.146 | NI | 2.106 | 0.821-5.400 | 0.121 | NI | ||||
ALB (g/L) | ≤ 40 / > 40 | 0.261 | 0.133-0.515 | 0.101 | NI | 0.437 | 0.153-1.244 | 0.121 | NI | ||||
TBIL (umol/L) | ≤ 20.5 / > 20.5 | 0.712 | 0.296-1.715 | 0.449 | NI | 0.360 | 0.083-1.569 | 0.174 | NI | ||||
IBIL (umol/L) | ≤ 15 / > 15 | 0.354 | 0.048-2.589 | 0.306 | NI | 0.043 | 0.001-77.525 | 0.411 | NI | ||||
CRP (ng/L) | ≤ 3 / > 3 | 3.312 | 1.582-6.936 | 0.001 | 1.741 | 0.757-4.005 | 0.192 | 3.094 | 1.136-8.428 | 0.127 | NI | ||
CEA (ng/mL) | ≤ 5 / > 5 | 1.029 | 0.527-2.011 | 0.933 | NI | 1.264 | 0.495-3.232 | 0.624 | NI | ||||
CA19-9 (U/ml) | ≤ 35 / > 35 | 1.745 | 0.676-4.507 | 0.250 | NI | 1.714 | 0.494-5.951 | 0.396 | NI | ||||
HBsAg | Negative/Positive | 0.220 | 0.030-1.610 | 0.136 | NI | 0.264 | 0.094-0.738 | 0.011 | NI | ||||
Chemotherapy | Without IRE/ With IRE | 0.206 | 0.082-0.515 | 0.001 | 0.363 | 0.132-0.998 | 0.050 | 0.264 | 0.094-0.738 | 0.011 | 0.313 | 0.098-0.992 | 0.048 |
Cheotherapy type | FOLFIRINOX/Gem | 0.910 | 0.648-1.277 | 0.584 | NI | 0.852 | 0.513-1.414 | 0.535 | NI |
Conclusions
IRE combined with chemotherapy is superior to chemotherapy alone in terms of OS, CSS and PFS for patients with LAPC. This combination method may be a more suitable way of treatment for patients with LAPC.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
The National Natural Science Funds (No. 81672390) and the National Key Research and Development Plan (No.2017YFC0910002).
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
2551 - Efficacy of dose-dense (DD) adjuvant chemotherapy (CT) in hormone receptor positive/HER2-negative early breast cancer (BC) patients (pts) according to immunohistochemically (IHC) defined luminal subtypes: an exploratory analysis of the GIM2 trial.
Presenter: Benedetta Conte
Session: Poster Display session 2
Resources:
Abstract
3426 - High dose Neo-adjuvant chemotherapy in Triple-Negative breast cancer with evidence of homologous recombination deficiency (HRD).
Presenter: Sonja Vliek
Session: Poster Display session 2
Resources:
Abstract
3792 - Risk factors for locoregional recurrence (LRR) after neoadjuvant chemotherapy: pooled analysis of prospective neoadjuvant breast cancer (BC) trials
Presenter: Gustavo Werutsky
Session: Poster Display session 2
Resources:
Abstract
4044 - Estimating radiotherapy-induced cardiovascular mortality in female breast cancer patients.
Presenter: Mark De Ridder
Session: Poster Display session 2
Resources:
Abstract
719 - 3-year follow-up of a phase III trial comparing the efficacy and safety of neoadjuvant and adjuvant trastuzumab and its biosimilar CT-P6 in HER2 positive early breast cancer (EBC)
Presenter: Justin Stebbing
Session: Poster Display session 2
Resources:
Abstract
3595 - Adjuvant chemotherapy in elderly breast cancer patients: pattern of use and impact on overall survival
Presenter: Axel Berthelot
Session: Poster Display session 2
Resources:
Abstract
3992 - Carboplatin-containing neoadjuvant chemotherapy for triple negative breast cancer (TNBC): a propensity score-matched study.
Presenter: Maria Vittoria Dieci
Session: Poster Display session 2
Resources:
Abstract
3477 - Impact of adjuvant trastuzumab emtansine (T-DM1) on incidence of metastatic breast cancer (mBC): an epidemiological model of patients with HER2-positive breast cancer (BC) who did not achieve pathological complete response (pCR) after neoadjuvant treatment (non-pCR)
Presenter: Mellissa Williamson
Session: Poster Display session 2
Resources:
Abstract
3928 - Chemotherapy (CT)-induced anaemia in patients (pts) treated with dose-dense regimen: Results of the prospectively randomised anaemia substudy from the neoadjuvant GeparOcto study
Presenter: Hans Tesch
Session: Poster Display session 2
Resources:
Abstract
2184 - The clinical impact of adjuvant dose-dense sequential chemotherapy (dds-CT) in patients with high-risk operable breast cancer (BC); pooled analysis of 6 clinical trials.
Presenter: Elena Fountzilas
Session: Poster Display session 2
Resources:
Abstract