TY - JOUR
T1 - Treatment strategies and clinical outcomes in consecutive patients with locally advanced pancreatic cancer
T2 - A multicenter prospective cohort
AU - Walma, Marieke S
AU - Brada, Lilly J
AU - Patuleia, Susana I S
AU - Blomjous, Joost G
AU - Bollen, Thomas L
AU - Bosscha, Koop
AU - Bruijnen, Rutger C
AU - Busch, Olivier R
AU - Creemers, Geert-Jan
AU - Daams, Freek
AU - van Dam, Ronald
AU - Festen, Sebastiaan
AU - Jan de Groot, Derk
AU - Willem de Groot, Jan
AU - Mohammad, Nadia Haj
AU - Hermans, John J
AU - de Hingh, Ignace H
AU - Kerver, Emile D
AU - van Leeuwen, Maarten S
AU - van der Leij, Christiaan
AU - Liem, Mike S
AU - van Lienden, Krijn P
AU - Los, Maartje
AU - de Meijer, Vincent E
AU - Meijerink, Martijn R
AU - Mekenkamp, Leonie J
AU - Nederend, Joost
AU - Nio, C Yung
AU - Patijn, Gijs A
AU - Polée, Marco B
AU - Pruijt, Johannes F
AU - Renken, Nomdo S
AU - Rombouts, Steffi J
AU - Schouten, Thijs J
AU - Stommel, Martijn W J
AU - Verweij, Maaike E
AU - de Vos-Geelen, Judith
AU - de Vries, Jan J J
AU - Vulink, Annelie
AU - Wessels, Frank J
AU - Wilmink, Johanna W
AU - van Santvoort, Hjalmar C
AU - Besselink, Marc G
AU - Molenaar, I Quintus
N1 - 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
PY - 2021/3
Y1 - 2021/3
N2 - 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 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.
AB - 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 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.
KW - FOLFIRINOX
KW - Locally advanced pancreatic cancer
KW - Treatment strategies
UR - http://www.scopus.com/inward/record.url?scp=85097227700&partnerID=8YFLogxK
U2 - 10.1016/j.ejso.2020.11.137
DO - 10.1016/j.ejso.2020.11.137
M3 - Article
C2 - 33280952
SN - 0748-7983
VL - 47
SP - 699
EP - 707
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
IS - 3
ER -