Treatment strategies and clinical outcomes in consecutive patients with locally advanced pancreatic cancer: A multicenter prospective cohort
Dutch Pancreatic Cancer Group
(2021) European Journal of Surgical Oncology, volume 47, issue 3, pp. 699 - 707
(Article)
Abstract
INTRODUCTION: Since current studies on locally advanced pancreatic cancer (LAPC) mainly report from single, high-volume centers, it is unclear if outcomes can be translated to daily clinical practice. This study provides treatment strategies and clinical outcomes within a multicenter cohort of unselected patients with LAPC. MATERIALS AND METHODS: Consecutive patients
... read more
with LAPC according to Dutch Pancreatic Cancer Group criteria, were prospectively included in 14 centers from April 2015 until December 2017. A centralized expert panel reviewed response according to RECIST v1.1 and potential surgical resectability. Primary outcome was median overall survival (mOS), stratified for primary treatment strategy. RESULTS: Overall, 422 patients were included, of whom 77% (n = 326) received chemotherapy. The majority started with FOLFIRINOX (77%, 252/326) with a median of six cycles (IQR 4-10). Gemcitabine monotherapy was given to 13% (41/326) of patients and nab-paclitaxel/gemcitabine to 10% (33/326), with a median of two (IQR 3-5) and three (IQR 3-5) cycles respectively. The mOS of the entire cohort was 10 months (95%CI 9-11). In patients treated with FOLFIRINOX, gemcitabine monotherapy, or nab-paclitaxel/gemcitabine, mOS was 14 (95%CI 13-15), 9 (95%CI 8-10), and 9 months (95%CI 8-10), respectively. A resection was performed in 13% (32/252) of patients after FOLFIRINOX, resulting in a mOS of 23 months (95%CI 12-34). CONCLUSION: This multicenter unselected cohort of patients with LAPC resulted in a 14 month mOS and a 13% resection rate after FOLFIRINOX. These data put previous results in perspective, enable us to inform patients with more accurate survival numbers and will support decision-making in clinical practice.
show less
Download/Full Text
Keywords: FOLFIRINOX, Locally advanced pancreatic cancer, Treatment strategies, Oncology, Surgery, Journal Article
ISSN: 0748-7983
Publisher: W.B. Saunders Ltd
Note: Funding Information: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: JGB has received grants, personal fees and non-financial support from Biotronik outside the submitted work; JWdG has received personal fees outside the submitted work from Bristol-Myers Squibb , Roche , Pierre-Fabre, Servier , MSD, Novartis; NHM reports advisory board fees for her institution from BMS, Eli Lilly, Servier, and MSD; IdH reports grants from Roche Pharmaceutical, QPS/RanD, and Medtronic, outside the submitted work; KvL reports personal fees and non-financial support from AngioDynamics, outside the submitted work; VEdM reports grants from Stichting Louise Vehmeijer and NWO and travel grants from Astellas, and from Neovii, outside the submitted work; MRM reports grants, personal fees and non-financial support from Angiodynamics, grants and personal fees from Medtronic Covidien, and non-financial support from Cascination, outside the submitted work. JdVG reports grants and non-financial support from Servier , outside the submitted work; JWW reports research grants from Servier , Halozyme , Novartis , Celgene , Astra Zeneca, Pfizer , Roche , Amgen , Merck and a consulting/advisory role for Servier and Celgene; HCvS has received a research grant from the Dutch Cancer Society, during and outside the submitted work; MGB has received a research grant from the Dutch Cancer Society during and outside the conduct of the study. IQM has received a research grant from the Dutch Cancer Society during the conduct of the study. For all other authors, there are no conflicts of interest. Funding Information: This work was supported by the Dutch Cancer Society [grant number 2014–7244]. The Dutch Cancer Society did not have any role in the design of the study, collection and analysis of data and decision to publish. Publisher Copyright: © 2020 The Authors
(Peer reviewed)
