scholarly journals P-163 Real-world outcomes of cisplatin, capecitabine and gemcitabine with either epirubicin (PEXG) or docetaxel (PDXG) as first-line palliative treatment in metastatic or unresectable locally advanced pancreatic adenocarcinoma

2021 ◽  
Vol 32 ◽  
pp. S155
Author(s):  
N. Waldron ◽  
N. Hitchen ◽  
S. Deva ◽  
G. Rivalland ◽  
M. Findlay ◽  
...  
2021 ◽  
Author(s):  
Shintaro Nakano ◽  
Yoshito Komatsu ◽  
Yasuyuki Kawamoto ◽  
Rika Saito ◽  
Ken Ito ◽  
...  

Abstract Background: Currently, it is unclear whether chemotherapy or chemoradiotherapy (CRT) is the optimal first-line treatment for patients with locally advanced pancreatic adenocarcinoma. In this study, we compared the efficacy and safety of FOLFIRINOX (FFX), gemcitabine plus nab-paclitaxel (GnP), and CRT as first-line treatments for locally advanced pancreatic adenocarcinoma. Methods: We evaluated patients receiving FFX, GnP, or CRT, and assessed treatment efficacy in terms of overall survival and progression-free survival. Safety was evaluated using the Common Toxicity Criteria for Adverse Events (version 4.0). Results: Fifty-five patients were included in the analysis (10 for FFX, 25 for GnP, and 20 for CRT). The median overall survival was 7.1, 16.9, and 20.0 months in the FFX, GnP, and CRT groups, respectively. There was no significant difference in overall survival between the FFX and GnP groups (HR: 0.503, 95% CI: 0.205–1.238, p = 0.135), FFX and CRT groups (HR: 0.518, 95% CI: 0.213–1.256, p = 0.136), or GnP and CRT groups (HR: 0.993, 95% CI: 0.451–2.188, p = 0.987). The 1-year survival rates were 40%, 64%, and 60%, whereas the 2-year survival rates were 0%, 16%, and 35% in the FFX, GnP, and CRT groups, respectively. Conclusions: Both chemotherapy and CRT were effective and well tolerated. Thus, the combination of intensive chemotherapy and radiotherapy may be a beneficial treatment strategy.


2020 ◽  
Author(s):  
Jonathan Garnier ◽  
Jacques Ewald ◽  
Ugo Marchese ◽  
Marine Gilabert ◽  
Simon Launay ◽  
...  

Abstract Background: The current study aimed to evaluate the outcomes of patients with unresectable non-metastatic locally advanced pancreatic adenocarcinoma (LAPA) who did not benefit from resection considering the treatment strategy in the clinical settings. Methods: Between 2010 and 2017, a total of 234 patients underwent induction chemotherapy for LAPA that could not be treated with surgery. After oncologic restaging, continuous chemotherapy or chemoradiation (CRT) was decided for patients without metastatic disease. The Kaplan–Meier method was used to determine overall survival (OS), and the Wilcoxon test to compare survival curves. Multivariate analysis was performed using the stepwise logistic regression method. Results: FOLFIRINOX was the most common induction regimen (168 patients, 72%), with a median of 6 chemotherapy cycles and resulted in higher OS, compared to gemcitabine (19 vs. 16 months, hazard ratio (HR)=1.2, 95% confidence interval: 0.86–1.6, P =.03). However, no difference was observed after adjusting for age (≤75 years) and performance status score (0–1). At restaging, 187 patients (80%) had non-metastatic disease: CRT was administered to 126 patients (67%) while chemotherapy was continued in 61 (33%). Patients who received CRT had characteristics comparable to those who continued with chemotherapy, with similar OS. They also had longer progression-free survival (median 13.3 vs. 9.6 months, HR=1.38, 95% confidence interval: 1–1.9, P <.01) and limited short-term treatment-related toxicity. Conclusions: The median survival of patients who could not undergo surgery was 19 months. Hence, CRT should not be eliminated as a treatment option and may be useful as a part of optimised sequential chemotherapy for both local and metastatic disease.


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