1517P - Isolated LUng Metastases in pancreatic AdenoCArcinoma patients in a multicenter Italian cohort: The LU.M.A.CA study

Background

Isolated lung metastases (ILM) from Pancreatic Ductal Adenocarcinoma (PDAC) are generally associated with better prognosis and more indolent behavior compared to other metastatic sites. Limited data are available on prognostic factors and therapy outcomes in PDAC patients (pts) with ILM.

Methods

Clinical data of PDAC pts with lung as first unique site of metastases/recurrence were retrospectively collected from 19 Italian Institutes. Two years from ILM diagnosis was the minimum required follow-up for alive pts. The impact of clinical variables and therapeutic strategies on Overall Survival (OS), calculated from ILM diagnosis to death/last follow-up visit, was assessed by Kaplan–Meier test and multivariate (MV) Cox proportional-hazards model.

Results

278 PDAC pts with ILM diagnosis (January 2001-March 2022) were included in the analysis (Table). Pts receiving only radical surgery (N=35) or stereotactic radiotherapy (N=6) as first treatment for ILM survived 85.1 (95% CI 36.9-131.4) and 35.3 (95% CI 16.5-55.1) months, respectively. Lower CA19.9 at ILM diagnosis, ECOG Performance Status (PS) 0, previous surgery on primary tumor and longer time to ILM onset were retained as positive prognostic factors at MV analysis, that showed no significant survival advantage for pts treated with standard polychemotherapy (nab-paclitaxel/gemcitabine-based, FOLFIRINOX) as opposed to monochemotherapy (gemcitabine, capecitabine). OS of 15 pts treated with no standard polychemotherapy was 12.0 (95% CI 6.8-36.4) months. Table: 1517P

Patients’ characteristics and survival outcomes