Copenhagen, Denmark
Onsite/Online

ESTRO 2022

Session Item

Upper GI
6010
Poster (digital)
Clinical
Prospective phase 2 study of induction FOLFIRINOX followed by chemoradiation in LA-Pancreatic Cancer
Gian Marco Petrianni , Italy
PO-1303

Abstract

Prospective phase 2 study of induction FOLFIRINOX followed by chemoradiation in LA-Pancreatic Cancer
Authors:

Gian Marco Petrianni1, Michele Fiore1, Pasquale Trecca1, Gabriele D'Ercole1, Luca Eolo Trodella1, Carlo Greco1, Edy Ippolito1, Damiano Caputo2, Roberto Coppola2, Sara Ramella1

1University Campus Bio-Medico of Rome, Radiotherapy, Rome, Italy; 2University Campus Bio-Medico of Rome, General Surgery, Rome, Italy

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Purpose or Objective

The aim of this study was to evaluate the safety and efficacy of induction treatments in patients with borderline resectable or unresectable locally advanced pancreatic cancer and the efficacy of pre-operatory staging with 18FDG PET-CT and laparoscopy in addition to CT scan.

Material and Methods

From 2015 to 2021 we evaluated 42 patients with borderline resectable or unresectable pancreatic cancer. A pre-treatment staging was performed with CT scan, 18FDG PET-CT scan and laparoscopy. Patients with metastatic disease were excluded. Suitable patients received induction treatments with FOLFIRINOX. After 4 cycles patients were restaged with CT scan and 18FDG PET-CT scan. Patients without evidence of metastatic disease started chemoradiation (CRT) with weekly gemcitabine. After CRT, before surgery evaluation, patients performed CT scan and 18-FDG PET-CT scan.

Results

Fifteen patients (39.5%) were excluded from the protocol because of the evidence of metastatic disease, and thus a total of twenty-three patients were consequently enrolled. Four patients (14.8%) had a progression of disease after induction chemotherapy. Median follow-up was 12.6 months. Nineteen patients (50%) completed CRT. Six patients (15.8%) had a progression of disease after CRT. Four patients are currently treating. Eleven patients underwent surgical radical resection (28.9%) (Fig.1). The median OS and the median PFS in patients who completed the therapeutic protocol were 15.7 months and 13 months, respectively. One-year OS, one-year PFS, one-year LPFS and one-year MPFS were 87.1%, 58.6%, 89.2% and 60%, respectively. Patients who underwent resection had a significant longer median OS compared with non-resected patients (17 months vs 13.2 months, p<0.05). The median PFS for resected patients was 14.5 months compared with 8.1 months for non-resected patients (p=0.07). For the entire cohort of patients the treatment was well tolerated. Only haematological grade 3-4 toxicities were observed.


Fig.1

Conclusion

Altough the follow-up time is limited, these preliminary data of the protocol treatment show promising results for patients with borderline resectable and unresectable pancreatic cancer. The best results were observed in patients who were resectable after the end of the study protocol. The enrollment is actually ongoing.