Annals of Oncology 27 (Supplement 6): vi207–vi242, 2016
doi:10.1093/annonc/mdw371.72
gastrointestinal tumours,
non-colorectal
680P Chemotherapy for patients with non-resectable pancreatic
cancer with additional chemo-radiotherapy for patients with
potentially resectable tumours: Final results
P. Pfeiffer1, M. Ladekarl2, M.B. Mortensen3, A-L. Fromm4, J.K. Bjerregaard1
1
Department of Oncology, Odense University Hospital, Odense, Denmark,
2
Department of Oncology, Aarhus University Hospital, Aarhus, Denmark,
3
Department of Surgery, Odense University Hospital, Odense, Denmark,
4
Department of Oncology, University Hospital Herlev, Herlev, Denmark
Background: Locally advanced pancreatic cancer (LAPC) is often a mix of borderline
and never-resectable tumors. Multimodality treatment might downstage these tumors
to allow a potential radical resection, especially the borderline group. In this ongoing
phase II study we examined the feasibility of FOLFIRINOX with or without CRT
followed by surgery for both borderline and never-resectable tumors (NCT-01397019).
Methods: Patients in performance status 0-1, with initially non-resectable stage II/III
pancreatic cancer were offered FOLFIRINOX (oxaliplatin 85 mg/m2, irinotecan 180
mg/m2, leucovorin 400 mg/m2, 5FU 400 mg/m2+ 2400 mg/m2) every 14 days. Every 4th
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series the patients were evaluated and offered CRT (50.4 Gy/27F & capecitabine) if
deemed potentially resectable. Resections were performed if deemed possible by the
MDT.
Results: Between August 2012 and present, 59 patients have been recruited with a
median observation time of 17.4 months. Median age was 65(range 38-75) years, with
40%/60% stage II/III distribution. Median CA19-9 was 268(range 1-13,432).
Three-hundred-sixty-two courses of FOLFIRINOX have been given, with a median of
6.0 per patient, with a median of 2 without dose modifications. Presently twenty-two
patients have been treated with CRT. Six-teen patients have been resected, of which 8
received prior CRT. Median survival for all patients was 21.1 months (14-NR) with a
1-year survival of 74% (58-85). For patients not resected the median survival was 14.1
months (10-16) for resected the median survival has not yet been reached. The
FOLFIRINOX was associated with adverse events similar to what is expected in
metastatic patients.
Conclusions: FOLFIRINOX with or without CRT in patients with LAPC shows
promising efficacy in patients with both borderline and never-resectable tumors.
Unmodified FOLFIRINOX had acceptable toxicity, however dose reductions are often
needed. CRT following initial FOLFIRINOX was feasible and without unexpected
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toxicity.
Clinical trial identification: NCT-01397019
Legal entity responsible for the study: N/A
Funding: Danish Pancreatic Cancer Group
Disclosure: All authors have declared no conflicts of interest.
abstracts