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Adding radiotherapy after four months of chemotherapy did not help patients with inoperable pancreatic cancer confined to the pancreas live longer, though it delayed regrowth at the original site. Nor did adding the pill erlotinib to gemcitabine. The result pushed radiotherapy out of the routine pathway for locally advanced disease.
International open-label randomised phase 3 trial with two randomisations: 449 patients with locally advanced pancreatic cancer received gemcitabine with or without erlotinib, and the 269 whose disease had not progressed after four months were randomised again to capecitabine-based chemoradiotherapy (54 Gy) or two further months of the same chemotherapy.
Median overall survival was 15.2 months with chemoradiotherapy and 16.5 months with chemotherapy alone (hazard ratio 1.03), and 11.9 against 13.6 months with and without erlotinib. Chemoradiotherapy reduced local progression (about 32 against 46 percent) and lengthened the interval off treatment, without more grade 3 or 4 toxicity apart from nausea.
Systemic chemotherapy is the backbone for locally advanced pancreatic cancer; consolidation chemoradiotherapy is an option to control local symptoms or as a bridge to surgery rather than a survival treatment.
Shares Tumor Treating Fields With Gemcitabine and Nab-Paclitaxel for Locally Advanced Pancreatic Adenocarcinoma: Randomized, Open-Label, Pivotal Phase III PANOVA-3 Study, LAP07, Locally advanced unresectable pancreatic ductal adenocarcinoma, Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question.
Shares LAP07, Locally advanced unresectable pancreatic ductal adenocarcinoma, Capecitabine, Gemcitabine.
Shares JAMA, Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question, Gemcitabine, Pancreatic ductal adenocarcinoma.
Shares Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question, Capecitabine, Gemcitabine, Pancreatic ductal adenocarcinoma.
Shares Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question, Capecitabine, Gemcitabine, Pancreatic ductal adenocarcinoma.
Shares JAMA, Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question, Gemcitabine, Pancreatic ductal adenocarcinoma.
Shares Locally advanced unresectable pancreatic ductal adenocarcinoma, Gemcitabine, Pancreatic ductal adenocarcinoma.
Shares Locally advanced unresectable pancreatic ductal adenocarcinoma, Gemcitabine, Pancreatic ductal adenocarcinoma.