Treatment strategies and clinical outcomes in consecutive patients with locally advanced pancreatic cancer: A multicenter prospective cohort

Dutch Pancreatic Cancer Group, Marieke S Walma, Lilly J Brada, Susana I S Patuleia, Joost G Blomjous, Thomas L Bollen, Koop Bosscha, Rutger C Bruijnen, Olivier R Busch, Geert-Jan Creemers, Freek Daams, Ronald van Dam, Sebastiaan Festen, Derk Jan de Groot, Jan Willem de Groot, Nadia Haj Mohammad, John J Hermans, Ignace H de Hingh, Emile D Kerver, Maarten S van LeeuwenChristiaan van der Leij, Mike S Liem, Krijn P van Lienden, Maartje Los, Vincent E de Meijer, Martijn R Meijerink, Leonie J Mekenkamp, Joost Nederend, C Yung Nio, Gijs A Patijn, Marco B Polée, Johannes F Pruijt, Nomdo S Renken, Steffi J Rombouts, Thijs J Schouten, Martijn W J Stommel, Maaike E Verweij, Judith de Vos-Geelen, Jan J J de Vries, Annelie Vulink, Frank J Wessels, Johanna W Wilmink, Hjalmar C van Santvoort, Marc G Besselink*, I Quintus Molenaar

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

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.

Original languageEnglish
Number of pages9
JournalEuropean Journal of Surgical Oncology
DOIs
Publication statusE-pub ahead of print - 26-Nov-2020

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