In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 30, No. 15_suppl ( 2012-05-20), p. 4051-4051
Abstract:
4051 Background: Preop therapy for resectable pancreatic cancer (PC) maximizes access to multimodality therapy and increases the R0 resection rate. Based on our phase I chemoradiation (chemoRT) trial in PC patients, we hypothesized that the addition of bev to gem-based chemoRT in pts with resectable PC may allow more pts to undergo pancreaticoduodenectomy (PD), improve the rate of R0 resections, and prolong overall survival. Methods: Pts with biopsy proven, stage I/II adenocarcinoma of the pancreatic head or uncinate process received 6 weekly infusions of gem (400 mg/m 2 ) and 3 infusions of bev (10 mg/kg, every 2 wks) with concomitant RT, 50.4 Gy at 1.8 Gy/fr. Pts were restaged 4-6 wks after the last dose of radiation. Those without disease progression and with good PS underwent surgery. Pts with adequate recovery received bev (10 mg/kg) every 2 weeks for 3 mo starting ~ 6 wks after surgery. Results: This study enrolled 11 of a planned 31 pts but was terminated early due to unforeseen postop complications. Median age is 64 yrs; all pts had ECOG-PS 0-1. Median CA19-9 was 52. Median follow-up from surgery was 41 mths. All completed chemoRT; 10 underwent restaging and 1 pt died from cardiac arrest before restaging. 9 pts (90 %) went to surgery and underwent a successful R0 PD. Pathologic PR rate ( 〉 50 % tumor kill) was 56 %. As we have previously reported, preop grade 3-4 toxicities were infrequent and major postop complications occurred in 5 of the 9 pts (56%) who underwent PD. Median overall survival (OS) was 30.1 mths (range: 2.6 - 63.9) for the entire cohort. Of the 9 resected pts, median OS was 45.5 mths with 5 of 11 pts (45%) achieving survival longer than best historical control (median 58.2 mths). Conclusions: The addition of bev to our prior backbone of gem-based preoperative chemoRT led to a higher resection rate (90%) than our previous protocols. Updated survival results of this study are promising. Taken together, these results may prompt further investigation of this regimen with modifications in the timing of bev delivery.
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/jco.2012.30.15_suppl.4051
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2012
detail.hit.zdb_id:
2005181-5
detail.hit.zdb_id:
604914-X
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