Neoadjuvant interferon‐based chemoradiation for borderline resectable and locally advanced pancreas cancer: a Phase II pilot study

ObjectivesNeoadjuvant chemoradiotherapy (CRT) is a viable treatment strategy for patients with pancreatic cancer. This study was conducted to evaluate the Virginia Mason Protocol (5‐fluorouracil, cisplatin, interferon‐α and radiation) given in the neoadjuvant setting for the treatment of locally advanced pancreatic cancer.MethodsA Phase II pilot study evaluating interferon‐based neoadjuvant CRT in patients with locally advanced pancreatic cancer was performed.ResultsA total of 23 patients were enrolled. The mean age of the patients was 58.6 years. Of the 23 patients, seven (30.4%) completed all treatments. In the remaining 16 (69.6%) patients, treatment was interrupted as a result of toxicity. The most commonly reported effects of toxicity were leucopoenia/cytopoenia (n = 19, 82.6%) and gastrointestinal effects (n = 19, 82.6%). Surgical resection was successful in seven (30.4%) patients. Margins were negative in six (85.7%) of these seven patients. Positive lymph nodes were identified in three (42.9%) of seven patients. Overall survival was 11.5 months. Surgery provided improved survival (22.6 months) compared with CRT alone (8.8 months). Disease‐free survival in resected patients was 17.2 months.ConclusionsInterferon‐based neoadjuvant CRT may allow for resection of locally advanced pancreatic cancer, but with significant toxicity. In the absence of surgical resection, survival remains dismal.