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
1109 - First Canadian Interim Analysis from the Phase IIIb CompLEEment-1 Ribociclib + Letrozole HR+ HER2- Advanced Breast Cancer Trial
Presenter: Cristiano Ferrario
Session: Poster Display session 2
Resources:
Abstract
4401 - Real-world effectiveness of first-line palbociclib + letrozole for metastatic breast cancer 4 years post approval in the US
Presenter: Jonathan Kish
Session: Poster Display session 2
Resources:
Abstract
5876 - Palbociclib-Fulvestrant (PALBO-FUL) and Everolimus -Exemestane (EVE-EXE) for Second line Hormonal Treatment (HT) of Metastatic Breast Cancer (MBC) with Lobular Histology: a Propensity Score Matched Analysis of a Multicenter ‘Real-World’ Patients (pts) Series.
Presenter: Armando Orlandi
Session: Poster Display session 2
Resources:
Abstract
3587 - Dose-escalation study of G1T48, an oral selective estrogen receptor degrader (SERD), in postmenopausal women with ER+/HER2- locally advanced or metastatic breast cancer (ABC)
Presenter: E Dees
Session: Poster Display session 2
Resources:
Abstract
5696 - Final results of the STEM trial: SFX-01 in the Treatment and Evaluation of ER+ Her2- Metastatic breast cancer (mBC)
Presenter: Sacha Howell
Session: Poster Display session 2
Resources:
Abstract
1475 - Alpelisib (ALP) + Fulvestrant (FUL) in Hormone-Receptor Positive (HR+), Human Epidermal Growth Factor Receptor-2–Negative (HER2–) Advanced Breast Cancer (ABC): Subgroup Analysis by Presence of Visceral Metastasis (VM) in the SOLAR-1 Trial
Presenter: Mario Campone
Session: Poster Display session 2
Resources:
Abstract
2549 - Phase 1 Dose Escalation Study of a Selective Androgen Receptor Modulator RAD140 in Estrogen Receptor Positive (ER+), HER2 Negative (HER2-) Breast Cancer (BC)
Presenter: Erika Hamilton
Session: Poster Display session 2
Resources:
Abstract
3787 - A Phase I study of XZP-3287, a novel oral CDK4/6 Inhibitor, administered on a continuous dosing schedule, in patients with advanced solid tumours
Presenter: Binghe Xu
Session: Poster Display session 2
Resources:
Abstract
4835 - Phase-I dose-escalation and expansion study of the PARP inhibitor, fluzoparib (SHR3162), in patients with advanced solid tumors
Presenter: Huiping Li
Session: Poster Display session 2
Resources:
Abstract
5083 - Phase 2 study of DHP107 (Liporaxel®, oral paclitaxel) in first-line, HER2 negative recurrent/metastatic breast cancer (OPTIMAL study, NCT03315364)
Presenter: Jin-Hee Ahn
Session: Poster Display session 2
Resources:
Abstract