Longer course of induction chemotherapy followed by chemoradiation favors better survival outcomes for patients with locally advanced pancreatic cancer

Farzana Faisal, Hua Ling Tsai, Amanda Blackford, Kelly Olino, Chang Xia, Ana De Jesus-Acosta, Dung T. Le, David Cosgrove, Nilofer Azad, Zeshaan Rasheed, Luis A. Diaz, Ross Donehower, Daniel Laheru, Ralph H. Hruban, Elliot K. Fishman, Barish H. Edil, Richard Schulick, Christopher Wolfgang, Joseph Herman, Lei Zheng

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objectives: At diagnosis, 30% of patients with pancreatic cancer are unresectable stage 3 locally advanced. The standard treatment for locally advanced pancreatic cancer (LAPC) is not defined. The current study was conducted to assess the roles of chemotherapy and chemoradiation for LAPC treatment. Materials and Methods: Between June 2006 and March 2011, 100 patients with LAPC were treated at the Johns Hopkins Hospital. Retrospective analysis was performed to compare cumulative incidence of progression (CIP) and overall survival (OS) among different subgroups. Results: For the 100 patients, the median OS was 15.8 months and the median CIP was 8.4 months. The combination of chemotherapy and chemoradiation before disease progression was significantly associated with improved CIP (P = 0.001) and improved OS when compared with chemoradiation alone (median OS: 16.4 vs. 11.1 mo, P = 0.03). Among patients receiving combination treatment, patients who received chemotherapy first followed by chemoradiation had a trend toward lower CIP (P = 0.09) and improved OS (median OS: 18.1 vs. 11.0 mo, P = 0.09). Patients who received >2 cycles of chemotherapy before chemoradiation had a significantly decreased CIP (P = 0.008) and a trend toward better OS (median OS: 19.4 vs. 15.7 mo, P = 0.10). On multivariate analysis, receiving

Original languageEnglish (US)
Pages (from-to)18-26
Number of pages9
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume39
Issue number1
DOIs
StatePublished - 2016
Externally publishedYes

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Induction Chemotherapy
Pancreatic Neoplasms
Survival
Incidence
Drug Therapy
Combination Drug Therapy
Disease Progression
Therapeutics
Multivariate Analysis

Keywords

  • Induction chemotherapy
  • Pancreatic cancer
  • Radiation

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Longer course of induction chemotherapy followed by chemoradiation favors better survival outcomes for patients with locally advanced pancreatic cancer. / Faisal, Farzana; Tsai, Hua Ling; Blackford, Amanda; Olino, Kelly; Xia, Chang; De Jesus-Acosta, Ana; Le, Dung T.; Cosgrove, David; Azad, Nilofer; Rasheed, Zeshaan; Diaz, Luis A.; Donehower, Ross; Laheru, Daniel; Hruban, Ralph H.; Fishman, Elliot K.; Edil, Barish H.; Schulick, Richard; Wolfgang, Christopher; Herman, Joseph; Zheng, Lei.

In: American Journal of Clinical Oncology: Cancer Clinical Trials, Vol. 39, No. 1, 2016, p. 18-26.

Research output: Contribution to journalArticle

Faisal, F, Tsai, HL, Blackford, A, Olino, K, Xia, C, De Jesus-Acosta, A, Le, DT, Cosgrove, D, Azad, N, Rasheed, Z, Diaz, LA, Donehower, R, Laheru, D, Hruban, RH, Fishman, EK, Edil, BH, Schulick, R, Wolfgang, C, Herman, J & Zheng, L 2016, 'Longer course of induction chemotherapy followed by chemoradiation favors better survival outcomes for patients with locally advanced pancreatic cancer', American Journal of Clinical Oncology: Cancer Clinical Trials, vol. 39, no. 1, pp. 18-26. https://doi.org/10.1097/COC.0000000000000022
Faisal, Farzana ; Tsai, Hua Ling ; Blackford, Amanda ; Olino, Kelly ; Xia, Chang ; De Jesus-Acosta, Ana ; Le, Dung T. ; Cosgrove, David ; Azad, Nilofer ; Rasheed, Zeshaan ; Diaz, Luis A. ; Donehower, Ross ; Laheru, Daniel ; Hruban, Ralph H. ; Fishman, Elliot K. ; Edil, Barish H. ; Schulick, Richard ; Wolfgang, Christopher ; Herman, Joseph ; Zheng, Lei. / Longer course of induction chemotherapy followed by chemoradiation favors better survival outcomes for patients with locally advanced pancreatic cancer. In: American Journal of Clinical Oncology: Cancer Clinical Trials. 2016 ; Vol. 39, No. 1. pp. 18-26.
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abstract = "Objectives: At diagnosis, 30{\%} of patients with pancreatic cancer are unresectable stage 3 locally advanced. The standard treatment for locally advanced pancreatic cancer (LAPC) is not defined. The current study was conducted to assess the roles of chemotherapy and chemoradiation for LAPC treatment. Materials and Methods: Between June 2006 and March 2011, 100 patients with LAPC were treated at the Johns Hopkins Hospital. Retrospective analysis was performed to compare cumulative incidence of progression (CIP) and overall survival (OS) among different subgroups. Results: For the 100 patients, the median OS was 15.8 months and the median CIP was 8.4 months. The combination of chemotherapy and chemoradiation before disease progression was significantly associated with improved CIP (P = 0.001) and improved OS when compared with chemoradiation alone (median OS: 16.4 vs. 11.1 mo, P = 0.03). Among patients receiving combination treatment, patients who received chemotherapy first followed by chemoradiation had a trend toward lower CIP (P = 0.09) and improved OS (median OS: 18.1 vs. 11.0 mo, P = 0.09). Patients who received >2 cycles of chemotherapy before chemoradiation had a significantly decreased CIP (P = 0.008) and a trend toward better OS (median OS: 19.4 vs. 15.7 mo, P = 0.10). On multivariate analysis, receiving",
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AU - Faisal, Farzana

AU - Tsai, Hua Ling

AU - Blackford, Amanda

AU - Olino, Kelly

AU - Xia, Chang

AU - De Jesus-Acosta, Ana

AU - Le, Dung T.

AU - Cosgrove, David

AU - Azad, Nilofer

AU - Rasheed, Zeshaan

AU - Diaz, Luis A.

AU - Donehower, Ross

AU - Laheru, Daniel

AU - Hruban, Ralph H.

AU - Fishman, Elliot K.

AU - Edil, Barish H.

AU - Schulick, Richard

AU - Wolfgang, Christopher

AU - Herman, Joseph

AU - Zheng, Lei

PY - 2016

Y1 - 2016

N2 - Objectives: At diagnosis, 30% of patients with pancreatic cancer are unresectable stage 3 locally advanced. The standard treatment for locally advanced pancreatic cancer (LAPC) is not defined. The current study was conducted to assess the roles of chemotherapy and chemoradiation for LAPC treatment. Materials and Methods: Between June 2006 and March 2011, 100 patients with LAPC were treated at the Johns Hopkins Hospital. Retrospective analysis was performed to compare cumulative incidence of progression (CIP) and overall survival (OS) among different subgroups. Results: For the 100 patients, the median OS was 15.8 months and the median CIP was 8.4 months. The combination of chemotherapy and chemoradiation before disease progression was significantly associated with improved CIP (P = 0.001) and improved OS when compared with chemoradiation alone (median OS: 16.4 vs. 11.1 mo, P = 0.03). Among patients receiving combination treatment, patients who received chemotherapy first followed by chemoradiation had a trend toward lower CIP (P = 0.09) and improved OS (median OS: 18.1 vs. 11.0 mo, P = 0.09). Patients who received >2 cycles of chemotherapy before chemoradiation had a significantly decreased CIP (P = 0.008) and a trend toward better OS (median OS: 19.4 vs. 15.7 mo, P = 0.10). On multivariate analysis, receiving

AB - Objectives: At diagnosis, 30% of patients with pancreatic cancer are unresectable stage 3 locally advanced. The standard treatment for locally advanced pancreatic cancer (LAPC) is not defined. The current study was conducted to assess the roles of chemotherapy and chemoradiation for LAPC treatment. Materials and Methods: Between June 2006 and March 2011, 100 patients with LAPC were treated at the Johns Hopkins Hospital. Retrospective analysis was performed to compare cumulative incidence of progression (CIP) and overall survival (OS) among different subgroups. Results: For the 100 patients, the median OS was 15.8 months and the median CIP was 8.4 months. The combination of chemotherapy and chemoradiation before disease progression was significantly associated with improved CIP (P = 0.001) and improved OS when compared with chemoradiation alone (median OS: 16.4 vs. 11.1 mo, P = 0.03). Among patients receiving combination treatment, patients who received chemotherapy first followed by chemoradiation had a trend toward lower CIP (P = 0.09) and improved OS (median OS: 18.1 vs. 11.0 mo, P = 0.09). Patients who received >2 cycles of chemotherapy before chemoradiation had a significantly decreased CIP (P = 0.008) and a trend toward better OS (median OS: 19.4 vs. 15.7 mo, P = 0.10). On multivariate analysis, receiving

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