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Attend this session at the
2018 ASCO Annual Meeting!


Session: Gastrointestinal (Noncolorectal) Cancer

Type: Poster Session

Time: Sunday June 3, 8:00 AM to 11:30 AM

Location: Hall A

Prognosis of resectable pancreatic cancer based on systemic therapy sequence and regimen: An NCDB analysis.

Sub-category:
Pancreatic Cancer

Category:
Gastrointestinal (Noncolorectal) Cancer

Meeting:
2018 ASCO Annual Meeting

Abstract No:
4120

Poster Board Number:
Poster Session (Board #309)

Citation:
J Clin Oncol 36, 2018 (suppl; abstr 4120)

Author(s): Aileen Deng, Chun Wang, Steven J. Cohen, Jordan Michael Winter, Atrayee Basu Mallick; Thomas Jefferson University Hospital, Philadelphia, PA; Thomas Jefferson University, Philadelphia, PA; Jefferson Health System/ Abington Memorial Hospital, Abington, PA; Memorial Sloan Kettering Cancer Center, New York, NY; NSABP Foundation and Thomas Jefferson University Hospital, Philadelphia, PA

Abstract Disclosures

Abstract:

Background: While surgical resection can cure pancreatic cancer (PC), the majority of patients who undergo resection recur. As newer multi-agent chemotherapy regimens have evolved for metastatic PC, there has been increased interest in its use in the neoadjuvant (NAT) setting. However, U.S. clinical practice patterns vary widely. We evaluated the effect of systemic therapy sequence and regimen on prognosis in resected PC. Methods: Adult patients with resected, clinical stage I or II PC were identified in the NCDB from 2010-2015. Patients who received NAT followed by resection were matched by a minimum distance approach with those who underwent upfront resection (UR) with or without adjuvant therapy (AT) based upon demographics and disease-specific variables. OS was compared with Kaplan-Meier curves in matched cohorts. The effects of single-agent (SA) versus multi-agent (MA) chemotherapy (CT) on OS was evaluated using multivariate Cox proportional hazards regression model. Results: We identified 23,576 patients with clinical stage I or II resected PC. 3,446 patients who received NAT were matched with 3,446 patients who underwent UR. Those who received NAT had improved OS compared to those who underwent UR with or without AT (median survival time [MST] 27.9 versus 23.3 months, respectively; log-rank p < 0.0001). Among different treatment sequences, patients who received both NAT and AT had the longest OS compared to those who received either NAT or AT alone (MST 31.3 versus 26.2 versus 26.5 months, respectively; log-rank p < 0.0001). In patients treated with NAT alone, those who received MA CT had an improved OS compared to those who received SA CT (adjusted HR 0.72, 95% CI 0.64-0.81). In patients who received MA chemotherapy, MA NAT was associated with an 18% reduction in risk of death compared to those treated with MA AT (adjusted HR 0.82, 95% CI 0.73-0.93). Conclusions: In resectable PC, patients who received both NAT and AT had improved survival compared to those who receive NAT or AT alone. This supports future evaluation of maintenance therapy in the adjuvant setting. MA NAT was associated with improved survival compared to SA NAT. This supports current clinical practice and ongoing clinical trials.

 
Other Abstracts in this Sub-Category:

 

1. FOLFIRINOX until progression, FOLFIRINOX with maintenance treatment, or sequential treatment with gemcitabine and FOLFIRI.3 for first-line treatment of metastatic pancreatic cancer: A randomized phase II trial (PRODIGE 35-PANOPTIMOX).

Meeting: 2018 ASCO Annual Meeting Abstract No: 4000 First Author: Laetitia Dahan
Category: Gastrointestinal (Noncolorectal) Cancer - Pancreatic Cancer

 

2. Unicancer GI PRODIGE 24/CCTG PA.6 trial: A multicenter international randomized phase III trial of adjuvant mFOLFIRINOX versus gemcitabine (gem) in patients with resected pancreatic ductal adenocarcinomas.

Meeting: 2018 ASCO Annual Meeting Abstract No: LBA4001 First Author: Thierry Conroy
Category: Gastrointestinal (Noncolorectal) Cancer - Pancreatic Cancer

 

3. Preoperative chemoradiotherapy versus immediate surgery for resectable and borderline resectable pancreatic cancer (PREOPANC-1): A randomized, controlled, multicenter phase III trial.

Meeting: 2018 ASCO Annual Meeting Abstract No: LBA4002 First Author: Geertjan Van Tienhoven
Category: Gastrointestinal (Noncolorectal) Cancer - Pancreatic Cancer

 

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