In locally advanced pancreatic cancer (LAPC), the combination of chemotherapy and radiotherapy is a widely used treatment option. We performed a pooled analysis, including an ex-ploratory analysis for prognostic and predictive factors, of two phase 2 trials including 73 patients with LAPC, treated with gemcitabine and oxaliplatin (GEMOX) and hypofractionated tomotherapy. With a median follow‐up of 36 months (range 1–65), median progression‐free (PFS) and overall survival (OS) were 10.2 (95% confidence interval [CI] 7.8–13.2) and 14.3 (95% CI 12.0–18.1) months, respectively. The overall resectability rate was 23.3% (95% CI 13.6–33.0), and the R0 resection rate was 13.7% (95% CI 5.8–21.6). In the multivariate analysis, ECOG performance status (PS) 0 and low levels of CA 19–9 were associated with improved OS and PFS. Concerning OS, log(CA19–9) resulted in a hazard ratio (HR) of 1.20 (95% CI 1.02–1.42), p = 0.027. For ECOG PS 0, HR was 1.00; for PS 1, HR was 2.69 (95% CI 1.46–4.96); for PS 2, HR was 4.18 (95% CI 0.90–19.46); p = 0.003. Low CA19–9 levels were also predictive for resection, with an odds ratio of 0.71 (95% CI 0.52–0.97), p = 0.034. In conclusion, GEMOX and hypofractionated radiotherapy is a treatment option in LAPC. Further studies are needed to identify differences in tumor biology, which may help to predict resectability and prognosis.

Passardi A., Rapposelli I.G., Scarpi E., Sullo F.G., Bartolini G., Neri E., et al. (2021). Multimodal treatment with gemox plus helical tomotherapy in unresectable locally advanced pancreatic cancer: A pooled analysis of two phase 2 studies. BIOMOLECULES, 11(8), 1-14 [10.3390/biom11081200].

Multimodal treatment with gemox plus helical tomotherapy in unresectable locally advanced pancreatic cancer: A pooled analysis of two phase 2 studies

Rapposelli I. G.
;
Tontini L.;Ercolani G.;Monti M.;Valgiusti M.;
2021

Abstract

In locally advanced pancreatic cancer (LAPC), the combination of chemotherapy and radiotherapy is a widely used treatment option. We performed a pooled analysis, including an ex-ploratory analysis for prognostic and predictive factors, of two phase 2 trials including 73 patients with LAPC, treated with gemcitabine and oxaliplatin (GEMOX) and hypofractionated tomotherapy. With a median follow‐up of 36 months (range 1–65), median progression‐free (PFS) and overall survival (OS) were 10.2 (95% confidence interval [CI] 7.8–13.2) and 14.3 (95% CI 12.0–18.1) months, respectively. The overall resectability rate was 23.3% (95% CI 13.6–33.0), and the R0 resection rate was 13.7% (95% CI 5.8–21.6). In the multivariate analysis, ECOG performance status (PS) 0 and low levels of CA 19–9 were associated with improved OS and PFS. Concerning OS, log(CA19–9) resulted in a hazard ratio (HR) of 1.20 (95% CI 1.02–1.42), p = 0.027. For ECOG PS 0, HR was 1.00; for PS 1, HR was 2.69 (95% CI 1.46–4.96); for PS 2, HR was 4.18 (95% CI 0.90–19.46); p = 0.003. Low CA19–9 levels were also predictive for resection, with an odds ratio of 0.71 (95% CI 0.52–0.97), p = 0.034. In conclusion, GEMOX and hypofractionated radiotherapy is a treatment option in LAPC. Further studies are needed to identify differences in tumor biology, which may help to predict resectability and prognosis.
2021
Passardi A., Rapposelli I.G., Scarpi E., Sullo F.G., Bartolini G., Neri E., et al. (2021). Multimodal treatment with gemox plus helical tomotherapy in unresectable locally advanced pancreatic cancer: A pooled analysis of two phase 2 studies. BIOMOLECULES, 11(8), 1-14 [10.3390/biom11081200].
Passardi A.; Rapposelli I.G.; Scarpi E.; Sullo F.G.; Bartolini G.; Neri E.; Ghigi G.; Tontini L.; Ercolani G.; Monti M.; Ruscelli S.; Matteucci L.; Va...espandi
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/861661
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