AB128. P104. Gemcitabine/taxane adjuvant therapy with chemoradiation in resected pancreatic cancer: a novel strategy for improved survival?

Background: Gemcitabine-taxane combination chemotherapy has demonstrated a survival benefit, clinically, in metastatic PC. We present our experience with gemcitabine/docetaxel (gem/tax) based adjuvant treatment (Rx) following curative intent surgery.

Methods: Patients with de-novo resectable PC from January 2010 to December 2015 were identified from our institutional database and registry. We only included those patients who received gem/tax as initial Rx administered exclusively at our institution ± chemoradiation (CRTx). Survival analysis was performed by Kaplan-Meier methods and prognostic factors were investigated by Cox proportional hazard modeling.

Results: Of 102 patients identified, 58 met study criteria. Median age of diagnosis was 65 years with 55% of patients undergoing an R1 resection (margin ≤1 mm). Tumor characteristics included: median tumor size 28 mm, poor differentiation 54% and lymph node positivity 67%. Ninety percent of patients (52/58) completed ≥80% of 24-week Rx. Of those, 71% received post gem/tax CRTx Rx. Grade 3/4 toxicity was observed in 52% of patients. Median length of follow-up was 51.2 months and the observed median overall survival (OS) was 52 months (95%CI: 27.4-NR). Actuarial 5-year OS was 49% (95%CI: 33.7-63.4). On multivariate analysis, an R1 resection and AJCC stage 2 vs. stage 1 were negatively associated with OS whereas administration of CRTx was positively associated with OS.

Conclusions: Adjuvant gem/tax ± CRTx is feasible with favorable OS. Future prospective studies of gem/taxane-based adjuvant Rx in PC are warranted.