ASCO 2022 abstracts

[RSAOaky]

These results are just like Julia Roberts' character in 'Pretty Woman'...
Richard Gere: What's your name?
Julia Roberts: It's whatever you want it to be.

You want to support chemoRT? Use this trial. You want not to use chemoRT? Use this trial. This trial is whatever you want it to be!

Very very true.
MedOnc will say "well we know FOLFIRINOX is better than Gemzar so the effectiveness of the chemo arm was diluted by inclusion of inferior chemo!" even though that's the way the trial was designed...

At the end of the day, it gives you more options to get to the same dismal result, but I think it opens more doors for RT than it closes. I just had two patients finish pancreatic long course (HEATHEN!) this week. Their only complaint at the end of treatment? Neuropathy.

If the subset analysis of the FOLFIRINOX arm shows 6 months FOLFIRINOX is equivalent or not significantly worse than 3 months FOLFIRINOX + 6 weeks of ChemoRT, then I think that's a win for CRT.

That is true, I am sorry, I missed that!

No worries, I'm sure there will be a lot of crossover in the final pub and I would absolutely agree with you that 3 months Gemzar monotherapy is preferable to RT

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[evilbooyaa]

Quite important results for RT in irresectable pancreatic cancer. Another negative trial.

https://meetings.asco.org/abstracts-presentations/208028

I mean LAP-07 already told us that RT doesn't improve OS in this scenario.

Interesting that this improved R0 resection rates. With palliative doses of RT this is likely the most we could ask for.

Which boils back to whether making a pancreatic tumor R0 matters, or whether it is the biology that inherently leads to a pancreatic cancer being at risk for R1 resection the main driver of mortality, compared to the biology of a pancreatic cancer that doesn't predispose to an infiltrate pattern thus leading to R0 resection.

If an unresectable patient was getting close to surgery, I think this trial actually supports using chemoRT to get them to a R0 resection. Perhaps at a longer median f/u there

I hate abstracts that don't define acronyms. I'm guessing CRM = circumferential resection margin? What's the difference between an R0 surgery and an R0 CRM- surgery? And isn't an R0 CRM+ surgery just...an R1 surgery?

I'm also confused as to the difference between R0, R0 CRM-, and R0 CRM+

 

[evilbooyaa]

based on the trial will you refer to a proton center next time you see one?

In a young breast Ca patient with good extracranial disease control who I feel would not tolerate photon CSI, sure I would.

The 2 proton centers closest to me don't do CSI though, for adults or kiddos.