A Phase II Study of Gemcitabine in Combination With Radiation Therapy in Patients With Localized, Unresectable, Pancreatic Cancer

Abstract

The activity and toxicity profile of combination GEM and RT indicates that this can be safely administered for patients with LAPC.

Resection of Borderline Resectable and Locally Advanced Pancreatic Adenocarcinomas after Neoadjuvant Chemotherapy

“…This compares favorably with the outcome reported with exclusive chemotherapy or radiochemotherapy [18,19] for the same category of patients. Our study confirms that it remains difficult to assess the response to preoperative treatment with conventional radiological or biological techniques and that the lack of progression after neoadjuvant systemic therapy currently remains the only selection criterion for surgery in pancreatic cancer patients with such LA disease.…”

Treatment of Locally Advanced Pancreatic Ductal Adenocarcinoma

“…Patients receiving chemotherapy in addition to chemoradiation had a median survival of 18.7 versus 12.4 months (p = 0.02) for patients receiving chemoradiation alone. Other studies, although underpowered, suggested that the addition of chemoradiation to gemcitabine therapy conferred a marginal survival benefit with comparable toxicity profiles [33,34]. Correspondingly, CRT usually follows induction chemotherapy which allows for identification of patients, approximately 30%, with initially undetected metastatic disease [35,36].…”

FOLFIRINOX induction therapy for stage III pancreatic adenocarcinoma

“…It does appear that resectability rates are higher following FOLFIRINOX then they are after non-FOLFIRINOX regimens [6][7][8][9][10][11][12][13] , in which the resectability rates for locally unresectable (stage III) patients treated with induction therapy have ranged between 7%-19%. Small et al 9 reported a multi-institutional phase II study, which assessed the efficacy of gemcitabine with concurrent radiation therapy in nonmetastatic PDAC patients.…”

“…During the pre-FOLFIRINOX era, the conversion rates of stage III patients with induction therapy ranged between 7-19% [6][7][8][9][10][11][12][13] . Currently, the resectability rates after induction FOLFIRINOX for stage III PDAC are not established, as recent series assessing FOLFIRINOX for non-metastatic patients have been either single-arm surgical series with a denominator limited to selected patients who were taken to the operating room, or series composed of a heterogonous population that included both resectable and locally unresectable patients 14 .…”