Chemotherapy before surgery benefits some patients with pancreatic cancer, study finds

Medical Xpress / Yale University / JAMA Oncology ^ | June 20, 2024 | Cecchini M. et al

[ConservativeMind]

Patients with pancreatic cancer who received chemotherapy both before and after surgery experienced longer survival rates than would be expected from surgery followed by chemotherapy, according to a new study.

The study included patients with pancreatic ductal adenocarcinoma (PDAC), which accounts for 90% of pancreatic cancers. An aggressive cancer with a high mortality rate, PDAC is predicted to become the second leading cause of cancer-related deaths in the U.S. by 2030.

The findings are encouraging for the 15 to 20% of pancreatic cancer patients whose tumors are operable.

The single-arm (only one treatment type or regimen) Phase II trial evaluated a modified form of the chemotherapy treatment FOLFIRINOX (a combination treatment consisting of leucovorin calcium, fluorouracil, irinotecan hydrochloride, and oxaliplatin approved in 2011 as a first-line treatment for patients with metastatic pancreatic cancer).

Patients in the trial received six cycles of the modified FOLFIRINOX before surgery, followed by an additional six cycles of the chemotherapy treatment after surgery. The modified regimen consisted of slightly lower doses of FOLFIRINOX to improve tolerability, which was previously shown in a 2016 publication not to impact outcomes negatively.

Of the 46 patients who started the modified treatment, 37 completed all six cycles of chemotherapy before surgery and 27 had successful tumor removal operations. For all enrolled patients, the 12-month progression-free survival rate—meaning the disease did not worsen—was 67%, indicating significant progress in controlling the disease. Furthermore, 59% of all patients lived at least two years after completing the full chemotherapy treatment plan and surgery..

"When the study launched, even with operable pancreatic cancers, 90% of patients were still relapsing and dying from their cancer eventually," said Dr. Michael Cecchini.

[ConservativeMind]

Apparently, this is taking the progression-free survival rate from 10% to 67%.

[ConservativeMind]

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[thinden]

thanx.

have 2 friends recently diagnosed