Experience of Spanish centers with echoendoscopically implanted 32 P microparticles associated with chemotherapy in locally advanced pancreatic adenocarcinoma.
Year: 2026
Type: conference-abstract
Abstract: 4232 Background: Phosphorous 32 microparticle ( 32 P) brachytherapy delivered by echoendoscopy (EUS) represents an innovative therapy in pancreatic cancer (PC). The device to implant it is approved in unresectable locally advanced PC in combination with gemcitabine-based chemotherapy. Our aim is to present the preliminary efficacy and safety results of a series that brings together the experience of thirteen centres in Spain. Methods: After being assessed by a multidisciplinary committee, patients signed consent to receive intratumoural 32 P by EUS. Complications associated with intratumoural 32P injection via EUS, associated adverse events (AEs) and preliminary efficacy results (progression-free survival [PFS], distant and locoregional, and overall survival [OS]) were analysed. Results: Fifty one patients (32 females and 19 males; age 65.5 years [range 48, 84]; 36 ECOG 1 and 14 ECOG 0) with unresectable locally advanced PC (30 in head, 5 in uncinate, 5 in neck and 11 in body; tumour size 30.8 mm [range 12, 60]) were included. The median time from tumour diagnosis to procedure was 5.9 months [0, 28.9]. Twenty-four patients (47 %) had received at least one previous line of treatment; four had received two prior lines. Fifty patients (98%) received gemcitabine-based chemotherapy concomitant with intratumoural 32P (42 gemcitabine plus nabpaclitaxel; 8 gemcitabine monotherapy. There were two AEs related to 32P injection by EUS: G1 epigastric pain (1 patient) and G2 asthenia (1 patient). A total of 30 patients (58.8%) had chemotherapy-related AEs, with 8 cases of G3 neutropenia (1 febrile neutropenia) and/or G3 thrombopenia; 22 had G1-2 toxicities: neurotoxicity (5), asthenia (4), neutropenia (3), thrombopenia (2), anaemia (4), nausea (2), diarrhoea (2), anorexia (1), onycholysis (1), mucositis (1), and constipation (1). Seven patients (13,7%) underwent surgery after intratumoural treatment (5 R0 and 2 R1). With a median follow-up of 8.7 months after injection (range: 1.02 months to 40.77 months), 25 patients (49.2 %) have progressed, 19 of them distantly, and nine also locoregionally. The median PFS since 32P injection is 8.5 months (95% CI 5.3, 17). 33 patients are alive at the end of follow-up (64.7%) with a median OS since 32P injection of 15.6 months 95% CI [10.2, 26.9]. Conclusions: Our experience suggests that intratumoural 32P associated with gemcitabine-based chemotherapy is safe. Patients after 32P injection achieve long overall survival. Surgical rescue was achieved in a high percentages of initially unresectable cases.
Source: Journal of Clinical Oncology
Authors: Carmen Guillen-Ponce, Elena Brozos, Martin Perez Martelo, Lucia Garcia Bernardo, Zulema Nogareda Seoane, Jose Larino-Noia, Virginia Pubul Nuñez, Rebeca Chulvi, Marisol Huerta, Alejandra Giménez, Ignacio Juez, Ignacio Navales, Ana Garcia de Paredes, Jorge Adeva, Joaquina Martínez-Galán, Mariano Ponz-Sarvise, Rafael Álvarez, Maria Purificacion Rodriguez Cernuda, Fayna Armas, Javier Zamora
Institutions: Hospital Universitario Ramón y Cajal, Complejo Hospitalario Universitario de Santiago, 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 de Fuenlabrada, Vall d'Hebron Hospital Universitari, Instituto Ramón y Cajal de Investigación Sanitaria, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Hospital Universitario 12 De Octubre, Hospital Universitario Virgen de las Nieves, Clinica Universidad de Navarra, Hospital Universitario HM Sanchinarro, Hospital Clínico Universitario de Valladolid, Universidad de Las Palmas de Gran Canaria, Hospital Universitario Insular de Gran Canaria
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W7162485541
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