PDAC: adjuvant therapy yields no OS benefit for tumors <1 cm

  • Shaib WL & al.
  • Cancer
  • 20 Nov 2018

  • curated by Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • Adjuvant therapy was associated with extended survival in patients with stage IA pancreatic ductal adenocarcinoma (PDAC) with tumors 1-2 cm in diameter, but not in patients with tumors

Why this matters

  • The study is the first to show that adjuvant therapy does not improve survival in patients with tumors this small.
  • Previous studies suggested adjuvant therapy is broadly effective, but patients with stage I disease were underrepresented in the study populations.

Study design

  • Retrospective analysis of 2004-2013 data from the National Cancer Data Base (n=1589) for patients diagnosed with T1 N0 resected PDAC.
  • Funding: Emory University; National Cancer Institute.

Key results

  • Overall, stage IA patients who received adjuvant therapy had a mean OS of 70.7 months compared with 46.9 months for those who did not receive adjuvant therapy (P=.0001).
  • Patients with tumors 1-2 cm in size gained an OS benefit with adjuvant therapy (64.5 vs 30.8 months; P<.0001>
  • Patients with subcentimeter tumors did not benefit: median OS was not reached in the adjuvant therapy group compared with 85.3 months with no additional treatment (P=.54).

Limitations

  • Retrospective design.

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