Pre-operative chemotherapy with radiation may help people with pancreatic cancer live longer

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Published: 4 Jun 2018
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Dr Geertjan van Tienhoven - Academic Medical Center, Amsterdam, Netherlands

Dr Van Tienhoven speaks with ecancer at the 2018 American Society of Clinical Oncology (ASCO) Annual Meeting about results from the PREOPANC-1 trial.

This was a phase III randomised trial in which patients with resectable pancreatic cancer received 10 weeks of chemoradiotherapy prior to surgery, or immediate surgery alone.

Median overall survival improved from 13.7 months to 17.1, disease recurrence from 7.9 months to 9.9 months, and two year survival rate from 30% to 42%

For more on these results, watch him present the results in a press conference here, or read news coverage here.

ecancer's filming has been kindly supported by Amgen through the ecancer Global Foundation. ecancer is editorially independent and there is no influence over content.

This morning’s presentation I presented our randomised clinical trial on pre-operative radio-chemotherapy rather than up-front surgery and adjuvant chemotherapy for resectable and borderline resectable pancreatic cancer.

The background of this trial is the circumstantial evidence that is available in the literature that pre-operative radio-chemotherapy might be better than post-operative adjuvant treatment but up to now there have been no randomised clinical trials to make the level 1 evidence for that.

Therefore a number of years we have decided with our pancreatic cancer, the Dutch Pancreatic Cancer Group, to perform this randomised clinical trial which is a full academic study that we did with the sixteen institutes that comprise this Dutch Pancreatic Cancer Group.

Can you tell us about the patient cohort recruited for this trial?

The patient cohort recruited was the patients that are sent to our multidisciplinary clinics with a diagnosis of pancreatic cancer that is resectable or borderline resectable based upon the CT findings, particularly of their vascular involvement of the tumour.

And when it came to the results from the chemoradiation, can you tell us about those?

The results of our trials, I must say, are preliminary because we are still short 26 events for the final results of this study. 

But the preliminary results are promising in the sense that all endpoints are positive, are in favour of pre-operative radio-chemotherapy, that is disease free survival, local control, metastasis free survival, also the survival is positive, but this is just not significant at the present time, with a p-value of 0.074.

When can we await further statistical validation?

We will wait for the final analysis when all 176 events have occurred.

We anticipate now that this will be in about half a year from now and then we will do the final analysis and publish the results.