Experience of 25 patients treated with echoendoscopically implanted 32 P microparticles associated with chemotherapy in locally advanced pancreatic adenocarcinoma.
Year: 2025
Type: conference-abstract
Abstract: e16455 Background: Phosphorous 32 microparticle ( 32 P) brachytherapy delivered by echoendoscopy (EUS) represents an innovative therapy in pancreatic cancer (PC). Our aim is to evaluate efficacy and safety outcomes for Spanish patients in real clinical practice. Methods: After being assessed by a multidisciplinary committee and meeting eligibility criteria (Table 1), patients signed consent to receive intratumoural 32 P by EUS within the international observational registry OSPREY (March 2022-January 2025). Complications associated with intratumoural 32P injection via EUS, associated adverse events (AEs) and preliminary efficacy results (progression-free survival [PFS] and overall survival [OS]) were analysed. Results: Twenty-five patients (16 females and 9 males; age 67 years [range 48, 80]; 20 ECOG 1 and 5 ECOG 0) with unresectable locally advanced PC (16 in head, 4 in uncinate and 5 in body; tumour size 31.5 mm [range 12, 60]) were included. Seven patients (28%) had received a previous treatment. 23 patients (92%) received gemcitabine-based chemotherapy concomitant with intratumoural 32P (17 gemcitabine plus nabpaclitaxel; 6 gemcitabine monotherapy), 1 patient FOLFIRINOX and 1 patient did not receive concomitant chemotherapy. Two patients had AEs related to 32P injection by EUS: G2 asthenia and G1 abdominal pain, respectively. Seventeen patients (68%) had chemotherapy-related AEs, with 3 cases of G3 neutropenia and 1 of G3 thombopenia; 14 had G1-2 toxicities: neutropenia (3), thrombopenia (4), neurotoxicity (4), anaemia (2), asthenia (3), hyporexia (1), nausea (1), diarrhea (1) and constipation (1) . Four (16%) patients underwent surgery after intratumoural treatment. With a median follow-up of 17.2 months after injection, 14 patients (56%) have progressed, 13 distantly and 7 also locoregionally; 1 patient progressed only locally. The median PFS since 32P injection is 8.4 months (95% CI 4.3, 17.0). 12 patients are alive at the end of follow-up (48%) with a median OS since 32P injection of 13.8 months (95% CI 9.4, 26,9]. Conclusions: The experience of Spanish centres suggests that intratumoural 32P associated with gemcitabine-based chemotherapy is safe and achieve long survival. Our ongoing prospective registry will allow evaluation of the oncological outcomes of this therapy at longer follow-up times. Eligibility criteria. Inclusion criteria Exclusion criteria - Patients eligible for and undergo 32P implantation at an eligible treatment facility according to the approved instructions for use, as part of their clinical care. - Patients participating in an interventional clinical study. - Patients who have completed and signed the patient informed consent form (PICF) for the OSPREY Patient Registry. - Patients using an investigational agent at the time of enrolment.
Source: Journal of Clinical Oncology
Authors: Carmen Guillen-Ponce, Ignacio Juez, Victoria Lopez-Gomez, Sonia Candamio Folgar, Ignacio Navales, Rebeca Chulvi, Marisol Huerta, Alejandra Giménez, Fayna Armas, Jorge Adeva, Maria Purificacion Rodriguez Cernuda, Mariano Ponz-Sarvise, Rafael Álvarez, Ana Garcia Garcia De Paredes, Javier Zamora
Institutions: Instituto Ramón y Cajal de Investigación Sanitaria, Hospital Universitario Ramón y Cajal, Hospital Universitario de Fuenlabrada, Complejo Hospitalario Universitario de Santiago, Vall d'Hebron Hospital Universitari, Hospital Universitario Doctor Peset, Universitat de València, Instituto de Salud Carlos III, INCLIVA Health Research Institute, Centro de Investigación Biomédica en Red de Cáncer, Hospital Universitari i Politècnic La Fe, Hospital Universitario Insular de Gran Canaria, Hospital Universitario 12 De Octubre, Hospital Clínico Universitario de Valladolid, Clinica Universidad de Navarra, Hospital Universitario HM Sanchinarro, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4410815855