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https://ascopubs.org/doi/abs/10.1200/JCO.2019.37.15_suppl.4125

GASTROINTESTINAL (NONCOLORECTAL) CANCER

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DOI: 10.1200/JCO.2019.37.15_suppl.4125Journal of Clinical Oncology- published online before print May 26, 2019

PanCO: An open-label, single-arm pilot study of phosphorus-32 (P-32; Oncosil) microparticles in patients with unresectable locally advanced pancreatic adenocarcinoma (LAPC) in combination with FOLFIRINOX or gemcitabine + nab-paclitaxel (GNP) chemotherapies.

Paul J. Ross,Daniel Croagh,Morteza Aghmesheh,Adnan Nagrial,Nam Nguyen,Mehrdad Nikfarjam,Harpreet Singh Wasan,Thankamma V. Ajithkumar,Chinenye Iwuji,Alain Hendlisz,Thomas Maher,Anna Kraszewski,Marion HarrisGuy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Monash Health, Clayton, Australia; Illawarra Cancer Care Centre, Wollongong, NSW, Australia; Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, Australia; Royal Adelaide Hospital, Adelaide, SA, Australia; Austin Health, Melbourne, VIC, Australia; Imperial College Healthcare NHS Trust, London, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; Oncology Department, Leicester, United Kingdom; Medical Oncology Department, Institut Jules Bordet - Université Libre de Bruxelles (ULB), Brussels, Belgium; OncoSil Medical Ltd, London, United Kingdom; OncoSil Medical Ltd, Sydney, NSW, Australia; Monash Medical Centre, Melbourne, AustraliaShow Less

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4125

Background:LAPC is associated with a poor prognosis. Current standard treatment is limited to chemotherapy or chemo-radiotherapy. P-32 Microparticles is a brachytherapy device that implants a predetermined dose of P-32 into pancreatic tumours via endoscopic ultrasound (EUS) guidance. This reports the initial results of a pilot study in combination with chemotherapy.Methods:Eligible patients were permitted to receive either GNP or FOLFIRINOX. P-32 was implanted at week 4 or 5. The dose of P-32 was calculated from tumour volume to deliver an absorbed dose of 100 Gy. Diffusion pattern of the P-32 suspension was assessed by EUS and bremsstrahlung SPECT/CT imaging. Safety data was graded using CTCAE v4.0 criteria. Response was assessed according to RECIST 1.1 with CT scans every 8 weeks and FDG-PET scans at baseline and week 12.Results:50 patients were enrolled (Intent-to-Treat population (ITT)) of which 42 were implanted with the device (Per Protocol population (PP)). 10 received FOLFIRINOX and 40 GNP. Median age was 65, 28 were male and all had a PS 0/1. 1070 adverse events (ITT) were reported; 153 (80% of patients) were ≥ Grade 3. The most common AEs of ≥ Grade 3 were haematological (39, 46%) and gastrointestinal disorders (30, 34%). No serious device- or radiation-related toxicities have been reported. PP Local Disease Control Rate at Week 16 was 90%; 95% CI: 77-97% and at Week 24 was 71%; 95% CI: 55-84%. Overall Response Rate (ORR) was 31%; 95% CI: 18-47%. Median change in tumour volume from Baseline to Week 16 and to Week 24 was -38% (range +89% to -90%) and -27.5% (range +139% to -79%). Ten (24%) patients underwent surgical resection following repeat staging. Eight patients had R0 margin.Conclusions:The use of EUS-guided implantation of P-32 is feasible, with an acceptable safety profile in combination with first-line chemotherapy for LAPC patients. Encouraging OR and DCR are observed. Further follow-up to inform results of local progression free survival and progression free survival is warranted. Acknowledgement: Nab-paclitaxel was supported by Specialised Therapeutics Australia Pty Ltd.