Abstract 1517P
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
| Variable | N | Median overall survival months | 95% Confidence interval | p | ||||
| Age, y | 0.01 | |||||||
| ≤68 | 140 | 29.3 | 24.0-42.3 | |||||
| >68 | 138 | 19.6 | 16.5-23.0 | |||||
| Gender | 0.92 | |||||||
| Male | 108 | 23.1 | 18.7-26.7 | |||||
| Female | 170 | 24.2 | 19.7-27.4 | |||||
| ECOG performance status | 0 | 110 | 16.5 | 14.0-19.4 | ||||
| Surgery on primary | ConclusionsOur study showed that radical surgery of ILM from PDAC is associated with remarkable OS and should be considered for pts with limited disease. Moreover, monochemotherapy might be regarded as a valid treatment option, especially for pts with favorable prognostic features (low CA19.9, PS0, surgery on primary, ILM onset timing>2 years). Clinical trial identificationEditorial acknowledgementLegal entity responsible for the studyThe authors. FundingHas not received any funding. DisclosureM. Scartozzi: Financial Interests, Personal, Advisory Board: AstraZeneca, GSK, Amgen, Merck, MSD, Servier, Daiichi Sankyo. M. Reni: Financial Interests, Personal, Funding: AstraZeneca; Financial Interests, Personal, Advisory Board: Eli Lilly, Panavance, Celgene, AstraZeneca, Viatris, Merck Sharp & Dohme, Servier, Sotio, Baxter. All other authors have declared no conflicts of interest. Resources from the same session1525P - Nab-paclitaxel/gemcitabine with or without epigenetic targeting followed by consolidating immune targeting with durvalumab and lenalidomide in patients with advanced pancreatic ductal adenocarcinoma: Results from the SEPION/AIO-PAK-0118 phase I/II studyPresenter: Jens Siveke Session: Poster session 18 1527P - GnP vs mFOLFIRINOX or S-IROX in metastatic pancreatic cancer: 1-year follow-up updated data from the GENERATE (JCOG1611)Presenter: Satoshi Kobayashi Session: Poster session 18 1528P - TCOG T5221 trial: A phase II randomized study of gemcitabine and nab-paclitaxel in combination with S- 1/LV (GASL) or oxaliplatin (GAP) as first-line treatment for metastatic pancreatic cancerPresenter: Yung-yeh Su Session: Poster session 18 1531TiP - TWINPEAK phase I/II study, PT886 a bispecific antibody targeting claudin 18.2 and CD47 in combination with chemotherapy and/or pembrolizumab in gastric/GEJ-carcinomas or PDACPresenter: Michael Overman Session: Poster session 18 1532TiP - Zolbetuximab with gemcitabine + nab-paclitaxel (GN) in first-line treatment of Claudin 18.2–positive metastatic pancreatic cancer (mPC): Phase II, open-label, randomized studyPresenter: Wungki Park Session: Poster session 18 1533TiP - A multicenter, open-label phase II study to evaluate the efficacy and safety of pimicotinib (CSF-1R inhibitor) in combination with chemotherapy with or without toripalimab in patients (pts) with advanced pancreatic ductal adenocarcinoma (aPDAC)Presenter: Xiaofei Zhang Session: Poster session 18 1534TiP - Valproic acid combinEd with Simvastatin and gemcitabine/nab-paclitaxel-based regimens in untreated metastatic Pancreatic Adenocarcinoma patients-VESPA trialPresenter: Alfredo Budillon Session: Poster session 18 This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used. For more detailed information on the cookies we use, please check our Privacy Policy.
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