Induction Chemo Beneficial in Locally Advanced Pancreatic CA
(HealthDay News) – For most patients with locally advanced pancreatic carcinoma (LAPC), induction with a combination of gemcitabine and oxaliplatin (GEMOX) followed by chemoradiotherapy (CRT) is feasible, resulting in clinical benefit, a chance of resectability, and improved survival, according to a study published online July 6 in Cancer.
Francesco Leone, MD, of the University of Turin in Candiolo, Italy, and colleagues conducted a single-institution study involving 39 patients with LAPC who were treated with GEMOX induction, followed by gemcitabine twice weekly, with concurrent radiotherapy for those who did not progress.
The researchers found that induction and maintenance treatments were well tolerated. Twenty-nine patients obtained disease control, two progressed after GEMOX induction therapy, and a further seven patients progressed after CRT. Median progression-free survival (PFS) at a median of 13 months of follow-up was 10.2 months, but varied from 9.1 months in those with unresectable disease to 16.6 months in those who were borderline resectable (P=0.056). The median overall survival was 16.7 months, ranging from 13.3 for patients with unresectable disease to 27.8 for those with borderline resectable disease (P=0.045). Following treatment, 11 patients were able to undergo a successful resection; this was associated with significantly improved PFS (19.7 vs.7.6 months) and median overall survival (31.5 vs.12.3 months), compared with nonresected patients.
"In conclusion, a regimen of induction chemotherapy with GEMOX followed by gemcitabine-based CRT for LAPC is feasible and well tolerated," the authors write. "A high disease control rate and clinical benefit are achievable in most patients."