ASCO GI: Adjuvant Chemotherapy Plus Chemoradiation May Improve Pancreatic Cancer Survival

ORLANDO, Jan. 29 -- Gemzar (gemcitabine) plus Eloxatin (oxaliplatin) adjuvant chemotherapy, followed by chemoradiation ,can improve one-year post-resection recurrence-free survival in pancreatic cancer, suggests a small French study.

"The adjuvant regimen has an encouraging 71% one-year recurrence-free survival," said radiation oncologist Franoise Mornex, M.D., of Centre Hospitalier in Lyon-Sud.

In a poster presented at a gastrointestinal cancers symposium here he reported on 49 of 54 patients in the study, 26 men and 23 women, - who completed at least two chemotherapy induction cycles.

The mean age of the participants was 59.2, ranging from 35 to 76. The median time from surgery to beginning chemotherapy was 43 days, ranging from 11 o 62. Most of the patients were Stage T2 or T3.

Dr. Mornex said 28 patients were diagnosed with N0 disease; 21 patients were diagnosed with N1 disease.

"The study treatment, including induction chemotherapy plus chemoradiation, was feasible and well-tolerated in its acute phase," said Dr. Mornex.

Patients who had no evidence of metastasis following surgery were placed on chemotherapy induction with Gemzar and Eloxatin within eight weeks after surgery.

On day one of the induction therapy, patients received Gemzar at 1,000 mg/m² in a 100-minute infusion. On day two they received Eloxatin at 100 mg/m² in a 120-minute infusion. Chemotherapy was repeated at 15-day intervals until six cycles were completed.

Following a four-week hiatus, concomitant radiation and chemotherapy was initiated.

In this phase patients were given Gemzar at 100 mg/m² in a 30- minute infusion once a week.

They also underwent Monday through Friday radiotherapy, receiving a total of 50 Gray, in 2 Gy fractions over a five-week period.

The total treatment period post surgery could lasted a maximum of 27 weeks.

Myelosuppression and gastrointestinal disorders were the main toxicities resulting from induction treatment, Dr. Mornex said.

Myelosuppression was also the main toxicity reported during chemoradiotherapy, he said.

Six of the patients were forced to discontinue the treatment because of serious adverse events. Four of the patients withdrew during the induction stage; two during the chemoradiation phase.

Secondary objectives - two year overall survival and toxicity - will be analyzed after the end of the 24-month follow-up, Dr. Mornex said.

The Gastrointestinal Cancers Symposium was jointly sponsored by American Society of Clinical Oncology, the American Society for Therapeutic Radiology and Oncology, the American Gastroenterological Association Institute, and the Society of Surgical Oncology.