Marieke S Walma1, Lilly J Brada1, Susana I S Patuleia2, Joost G Blomjous3, Thomas L Bollen4, Koop Bosscha5, Rutger C Bruijnen4, Olivier R Busch6, Geert-Jan Creemers7, Freek Daams6, Ronald van Dam8, Sebastiaan Festen9, Derk Jan de Groot10, Jan Willem de Groot11, Nadia Haj Mohammad12, John J Hermans13, Ignace H de Hingh14, Emile D Kerver15, Maarten S van Leeuwen4, Christiaan van der Leij16, Mike S Liem17, Krijn P van Lienden18, Maartje Los12, Vincent E de Meijer19, Martijn R Meijerink18, Leonie J Mekenkamp20, Joost Nederend21, C Yung Nio18, Gijs A Patijn22, Marco B Polée23, Johannes F Pruijt24, Nomdo S Renken25, Steffi J Rombouts1, Thijs J Schouten2, Martijn W J Stommel26, Maaike E Verweij2, Judith de Vos-Geelen27, Jan J J de Vries18, Annelie Vulink28, Frank J Wessels4, Johanna W Wilmink29, Hjalmar C van Santvoort2, Marc G Besselink30, I Quintus Molenaar2. 1. Dept. of Surgery, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, the Netherlands; Dept. of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. 2. Dept. of Surgery, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, the Netherlands. 3. Dept. of Radiology, OLVG, Amsterdam, the Netherlands. 4. Dept. of Radiology, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, the Netherlands. 5. Dept. of Surgery, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands. 6. Dept. of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. 7. Dept. of Medical Oncology, Catharina Hospital, Eindhoven, the Netherlands. 8. Dept. of Surgery, Maastricht UMC+, Maastricht, the Netherlands. 9. Dept. of Surgery, OLVG, Amsterdam, the Netherlands. 10. Dept. of Medical Oncology, UMC Groningen, Groningen, the Netherlands. 11. Dept. of Medical Oncology, Isala Clinics, Zwolle, the Netherlands. 12. Dept. of Medical Oncology, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, the Netherlands. 13. Dept. of Radiology, Radboud University Medical Center, Nijmegen, the Netherlands. 14. Dept. of Surgery, Catharina Hospital, Eindhoven, the Netherlands. 15. Dept. of Medical Oncology, OLVG, Amsterdam, the Netherlands. 16. Dept. of Radiology, Maastricht UMC+, Maastricht, the Netherlands. 17. Dept. of Surgery, Medical Spectrum Twente, Enschede, the Netherlands. 18. Dept. of Radiology Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amstrdam, the Netherlands. 19. Dept. of Surgery, UMC Groningen, Groningen, the Netherlands. 20. Dept. of Medical Oncology, Medical Spectrum Twente, Enschede, the Netherlands. 21. Dept. of Radiology, Catharina Hospital, Eindhoven, the Netherlands. 22. Dept. of Surgery, Isala Clinics, Zwolle, the Netherlands. 23. Dept. of Medical Oncology, Medical Center Leeuwarden, Leeuwarden, the Netherlands. 24. Dept. of Medical Oncology, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands. 25. Dept. of Radiology, Reinier de Graaf Hospital, Delft, the Netherlands. 26. Dept. of Surgery, Radboud University Medical Center, Nijmegen, the Netherlands. 27. Dept. of Medical Oncology, GROW - School for Oncology and Developmental Biology, Maastricht UMC+, Maastricht, the Netherlands. 28. Dept. of Medical Oncology, Reinier de Graaf Hospital, Delft, the Netherlands. 29. Dept. of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam; the Netherlands. 30. Dept. of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. Electronic address: m.g.besselink@amc.nl.
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.
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.
Authors: Michael D Chuong; Roberto Herrera; Adeel Kaiser; Muni Rubens; Tino Romaguera; Diane Alvarez; Rupesh Kotecha; Matthew D Hall; James McCulloch; Antonio Ucar; Fernando DeZarraga; Santiago Aparo; Sarah Joseph; Horacio Asbun; Ramon Jimenez; Govindarajan Narayanan; Alonso N Gutierrez; Kathryn E Mittauer Journal: Front Oncol Date: 2022-06-23 Impact factor: 5.738
Authors: Thijs J Schouten; Lois A Daamen; Galina Dorland; Stijn R van Roessel; Vincent P Groot; Marc G Besselink; Bert A Bonsing; Koop Bosscha; Lodewijk A A Brosens; Olivier R Busch; Ronald M van Dam; Arantza Fariña Sarasqueta; Sebastiaan Festen; Bas Groot Koerkamp; Erwin van der Harst; Ignace H J T de Hingh; Martijn Intven; Geert Kazemier; Vincent E de Meijer; Vincent B Nieuwenhuijs; G Mihaela Raicu; Daphne Roos; Jennifer M J Schreinemakers; Martijn W J Stommel; M F van Velthuysen; Robert C Verdonk; Joanne Verheij; Helena M Verkooijen; Hjalmar C van Santvoort; I Quintus Molenaar Journal: Ann Surg Oncol Date: 2022-04-25 Impact factor: 4.339