KEY TAKEAWAYS
- This study analyzed data from prospective AIO trials: Gem/Cis, Ro96, RC57, RASH, and ACCEPT, conducted between December 1997 and January 2017.
- Over two decades, survival rates improved for patients with advanced pancreatic cancer in AIO trials.
- Combination treatments didn’t show significant benefits over mono-chemotherapy, irrespective of age or gender.
Over the last twenty years, researchers led five IITs (investigator-initiated trials) focused on advanced pancreatic cancer—this pooled analysis aimed to observe treatment patterns and prognostic shifts over time.
The study included patient data from the AIO trials named Gem/Cis, Ro96, RC57, RASH, and ACCEPT, which ran from December 1997 to January 2017. The Kaplan-Meier method assessed time-to-event endpoints, and researchers executed subgroup analysis based on clinical variables.
Of 860 patients (pts) analyzed, 88% (780 pts) died, with a median survival of 7.3 months. Notably, 19.9% died within three months post-trial enrollment. Treatment outcomes showed a marked improvement, with pts treated between 2012-2017 having a median survival of 9.3 months versus those between 1997-2006 at 7.0 months. Factors like ECOG, second-line treatment, CA 19-9 levels, and UICC stage (III vs. IV) significantly impacted survival, while age and gender did not.
In specific comparisons, combination therapy didn’t outperform mono-chemotherapy, and regimes containing EGFR-TKI (erlotinib, afatinib) were on par with chemotherapy-only treatments. Similarly, platinum-based treatments didn’t show a distinct survival advantage. Early-onset (EO) pancreatic cancer pts (age ≤ 50) exhibited comparable survival rates to those over 51. Lastly, early-onset pts didn’t benefit more from platinum-based first-line chemotherapy.
Over two decades, the OS in pts with advanced pancreatic cancer improved in the AIO trials. Combination therapies didn’t show a distinct survival advantage over mono-chemotherapy. Due to the complexities in comparing different trial treatment arms, further prospective analysis regarding the influence of variables like age and gender on treatment selection for pancreatic cancer is advised.
Source: https://www.annalsofoncology.org/article/S0923-7534(23)00620-8/fulltext
Clinical Trials: https://classic.clinicaltrials.gov/ct2/show/NCT00440167
https://classic.clinicaltrials.gov/ct2/show/NCT01729481
https://classic.clinicaltrials.gov/ct2/show/NCT01728818
Weiss, L., Heinemann, V., Fischer, L., Gieseler, F., Hoehler, T., Mayerle, J., Quietzsch, D., Reinacher-Schick, A., Schenk, M., Seipelt, G., Siveke, J., Stahl, M., Vehling-Kaiser, U., Waldschmidt, D., Dorman, K., Zhang, D., Westphalen, B., Haas, M., Boeck, S. SO-6 Changes in the course of advanced pancreatic cancer treatment with systemic chemotherapy: A pooled analysis of five clinical trials from two decades of clinical research within the German AIO Study-Group. https://doi.org/10.1016/j.annonc.2023.04.478
