Australasian Gastro-Intestinal Trials Group (AGITG) MASTERPLAN: Randomized phase II study of modified neoadjuvant FOLFIRINOX alone or in combination with stereotactic radiotherapy (SBRT) for patients with high-risk and locally advanced pancreatic cancer.

Authors

null

Andrew Oar

Gold Coast University Hospital, Southport, Australia

Andrew Oar , Andrew Kneebone , Mark Lee , David Goldstein , Katrin Marie Sjoquist , Hien Le , Julie Chu , Andrew Barbour , Leily Gholamrezaei , James F. Lynam , Andrej Bece , Sandra Bahamad , Sonia Yip , David Espinoza , Lorraine A. Chantrill , Alisha Moore , Dominique Lee , Quoc Nam Nguyen , Jaswinder Samra , No Firstname Jan.Mumford@Tics.Com.Au

Organizations

Gold Coast University Hospital, Southport, Australia, Department of Radiation Oncology, Royal North Shore Hospital, St Leonards, Australia, Liverpool and Macarthur Cancer Therapy Centres, Sydney, NSW, Australia, Prince of Wales Hospital, University of New South Wales, Cancer Survivors Centre, Randwick, Australia, NHMRC Clinical Trials Centre, The University of Sydney, Sydney, Australia, Royal Adelaide Hospital, Adelaide, SA, Australia, Peter MacCallum Cancer Centre, Melbourne, Australia, University of Queensland, Brisbane, Australia, Chris O'Brien Lifehouse, Sydney, NSW, Australia, Calvary Mater Newcastle Hospital, Newcastle, Australia, St George Hospital, Sydney, NSW, Australia, NHMRC Clinical Trials Centre, Sydney, NSW, Australia, Sydney Catalyst Translational Cancer Research Centre, Sydney, Australia, NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia, Macarthur Cancer Therapy Centre, The Kinghorn Cancer Centre and University of Western Sydney, Sydney, Australia, Trans-Tasman Radiation Oncology Group, Newcastle, NSW, Australia, Princess Alexandra Hospital, Woolloongabba, QLD, Australia, University of Adelaide, Adelaide, Australia, Royal North Shore Hospital, Sydney, NSW, Australia, Australasian Gastro-Intestinal Trials Group, Sydney, NSW, Australia

Research Funding

Other Government Agency
Medical Research Future Fund (MRFF)

Background: Eighty per cent of patients with non-metastatic pancreatic cancer have high-risk, borderline resectable (BRPC) or locally advanced pancreas cancer (LAPC), conferring a 5-year overall survival of only 12%. MASTERPLAN evaluates the safety and activity of stereotactic body radiotherapy (SBRT) added to neoadjuvant chemotherapy in these patient cohorts. Methods: MASTERPLAN is an investigator-initiated prospective multi-centre randomized phase II trial. Inclusion criteria include histologically confirmed high-risk, BRPC or LAPC. High risk is defined as tumour > 4cm, extrapancreatic extension or node positive. Randomisation is 2:1 to chemotherapy + SBRT (investigational arm) or chemotherapy (control arm) by minimisation with stratification by operability (potentially operable - high risk; BRPC versus inoperable – LAPC; medically inoperable), planned chemotherapy and institution. Both treatment arms receive 6 x 2 weekly cycles of modified FOLFIRINOX (mFOLFIRINOX). Gemcitabine and nab-paclitaxel is permitted if mFOLFIRINOX is unsuitable. The investigational arm receives SBRT (40Gy in 5 fractions) with real time quality assurance. Resectability will be evaluated following initial chemotherapy +/- SBRT. Adjuvant chemotherapy is 6 cycles (12 weeks) of mFOLFIRINOX, or the same duration of gemcitabine and capecitabine (GEMCAP) if neoadjuvant gemcitabine/nab-paclitaxel given. SBRT adverse events (AEs) will be recorded until study cessation. The primary endpoint is 12-month locoregional control. Secondary endpoints: safety, surgical morbidity and mortality, radiological response rate, progression free survival, pathological response rate, surgical resection rate, R0 resection rate, quality of life, deterioration free survival and overall survival. Biospecimens are collected for translational research for potential prognostic/predictive biomarkers of clinical endpoints and include serial tumour tissue collection from patients undergoing fiducial marker insertion and/or surgery, biopsy at disease progression, serial blood collection and serial buccal and faecal sample collection. An interim analysis will review locoregional failure, distant metastasis and rate of death on the first 40 patients after completion of 12 months follow up. The sample size is 120 patients (80 intervention:40 control), balanced for BRPC/LAPC (60 in each cohort). The minimum follow up is 12 months. The first site opened in October 2019 and 10 patients have been recruited from five sites at 17 Feb 2021. Overall 15 sites in Australia and New Zealand are planned to open to recruitment. Australian Clinical Trials Registry Number: ACTRN12619000409178. Clinical trial information: ACTRN12619000409178.

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Abstract Details

Meeting

2021 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Gastrointestinal Cancer—Gastroesophageal, Pancreatic, and Hepatobiliary

Track

Gastrointestinal Cancer—Gastroesophageal, Pancreatic, and Hepatobiliary

Sub Track

Pancreatic Cancer

Clinical Trial Registration Number

ACTRN12619000409178

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr TPS4172)

DOI

10.1200/JCO.2021.39.15_suppl.TPS4172

Abstract #

TPS4172

Poster Bd #

Online Only

Abstract Disclosures