ESPAC-5F: Four-arm, prospective, multicenter, international randomized phase II trial of immediate surgery compared with neoadjuvant gemcitabine plus capecitabine (GEMCAP) or FOLFIRINOX or chemoradiotherapy (CRT) in patients with borderline resectable pancreatic cancer.

Published on May 25, 2020in Journal of Clinical Oncology32.956
· DOI :10.1200/JCO.2020.38.15_SUPPL.4505
Paula Ghaneh62
Estimated H-index: 62
(University of Liverpool),
Daniel H. Palmer44
Estimated H-index: 44
+ 17 AuthorsJohn P. Neoptolemos125
Estimated H-index: 125
(University of Liverpool)
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Abstract
4505Background: Patients with borderline resectable pancreatic cancer have poor survival and low resection rates. Neoadjuvant therapy may improve the outcome for these patients. The aim of this tri...
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Cited By37
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#1Erin P Ward (MCW: Medical College of Wisconsin)
#2Herbert J. Zeh (University of Texas at Austin)
Last. Susan Tsai (MCW: Medical College of Wisconsin)H-Index: 32
view all 3 authors...
Over the last two decades, there have been significant changes in the management of patients with localized pancreatic cancer. The rationale for an evolution toward a neoadjuvant approach and summary of relevant clinical trials is reviewed. Controversies in identifying optimal neoadjuvant therapeutic approaches are discussed.
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#1Siddharth Iyengar (UofU: University of Utah)H-Index: 1
#2Christopher Nevala-Plagemann (HCI: Huntsman Cancer Institute)H-Index: 3
Last. Ignacio Garrido-Laguna (HCI: Huntsman Cancer Institute)H-Index: 26
view all 3 authors...
Pancreatic cancer is the third leading cause of cancer-related mortality in the US. Outcomes for patients with pancreatic cancer are poor as curative approaches are only available to the minority of patients who have localized tumors for which surgery may be an option. The past decade has established fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX) as the new standard of care following resection for fit patients with resectable pancreatic tumors. However, most patients will rel...
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#1Shelize Khakoo (The Royal Marsden NHS Foundation Trust)H-Index: 5
#2Angelica Petrillo (Seconda Università degli Studi di Napoli)H-Index: 13
Last. Michele Ghidini (Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico)H-Index: 23
view all 9 authors...
Pancreatic ductal adenocarcinoma (PDAC) has an aggressive tumor biology and is associated with poor survival outcomes. Most patients present with metastatic or locally advanced disease. In the 10–20% of patients with upfront resectable disease, surgery offers the only chance of cure, with the addition of adjuvant chemotherapy representing an established standard of care for improving outcomes. Despite resection followed by adjuvant chemotherapy, at best, 3-year survival reaches 63.4%. Post-opera...
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#1Patrick MichlH-Index: 15
#2Matthias Löhr (Karolinska University Hospital)H-Index: 55
Last. Luigi Ricciardiello (UNIBO: University of Bologna)H-Index: 35
view all 8 authors...
BACKGROUND Pancreatic ductal adenocarcinoma is the deadliest cancer worldwide with a 98% loss-of-life expectancy and a 30% increase in the disability-adjusted life years during the last decade in Europe. The disease cannot be effectively prevented nor being early detected. When diagnosed, 80% of patients have tumors that are in incurable stages, while for those who undergo surgery, 80% of patients will present with local or distant metastasis. Importantly, chemotherapies are far from being effec...
1 CitationsSource
#1Andrew OarH-Index: 4
#2Mark A LeeH-Index: 23
Last. Jaswinder S. Samra (RNSH: Royal North Shore Hospital)H-Index: 34
view all 0 authors...
BACKGROUND Among patients with non-metastatic pancreatic cancer, 80% have high-risk, borderline resectable or locally advanced cancer, with a 5-year overall survival of 12%. MASTERPLAN evaluates the safety and activity of stereotactic body radiotherapy (SBRT) in addition to chemotherapy in these patients. METHODS AND DESIGN MASTERPLAN is a multi-centre randomised phase II trial of 120 patients with histologically confirmed potentially operable pancreatic cancer (POPC) or inoperable pancreatic ca...
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#1Ganesh RadhakrishnaH-Index: 11
#2Paula Ghaneh (University of Liverpool)H-Index: 62
The treatment paradigm for borderline and locally advanced pancreatic cancer is evolving with an increased shift towards utilising systemic chemotherapy and chemoradiation to potentially facilitate more curative resections. This has been driven by the improved outcomes from the use systemic combination chemotherapy on its own, or sequentially with chemoradiation, resulting in improved resection rates and survival outcomes.
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#1John R. Bergquist (Mayo Clinic)H-Index: 12
#2Cornelius A. Thiels (Mayo Clinic)H-Index: 18
Last. Michael L. Kendrick (Mayo Clinic)H-Index: 58
view all 12 authors...
Introduction null Although surgical resection is necessary, it is not sufficient for long-term survival in pancreatic ductal adenocarcinoma (PDAC). We sought to evaluate survival after up-front surgery (UFS) in anatomically resectable PDAC in the context of three critical factors: (A) margin status; (B) CA19-9; and (C) receipt of adjuvant chemotherapy. null Methods null The National Cancer Data Base (2010-2015) was reviewed for clinically resectable (stage 0/I/II) PDAC patients. Surgical margins...
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#1Ahmad Hamad (The Ohio State University Wexner Medical Center)H-Index: 2
#2Zachary J. Brown (The Ohio State University Wexner Medical Center)
Last. Jordan M. Cloyd (The Ohio State University Wexner Medical Center)H-Index: 24
view all 5 authors...
Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy that is best treated in a multidisciplinary fashion using surgery, chemotherapy, and radiation. Adjuvant chemotherapy has shown to have a significant survival benefit in patients with resected PDAC. However, up to 50% of patients fail to receive adjuvant chemotherapy due to postoperative complications, poor patient performance status or early disease progression. In order to ensure the delivery of chemotherapy, an alternative st...
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