Allan Pereira, GI Medical Oncologist and Researcher, Associate Member at Moffitt Cancer Center, shared on X:
“MASTERPLAN – randomised Phase 2 (Lancet Oncology)
This is the clearest randomized evidence so far that ablative-range neoadjuvant SBRT after modern chemo decreases locoregional recurrence.
- High-risk localised PDAC: >4 cm, node-positive, borderline or LAPC
- mFOLFIRINOX or gem-nab-paclitaxel ± SBRT 40 Gy/5 fx
- 74 patients, closed early (120 planned)
- 12-mo locoregional recurrence 20.2% vs 52.0%, sHR 0.44
- Grade ≥3 AEs 70% vs 64%
- No survival endpoint reported
Why did it close early ? slow accrual.
Powered for PFS and OS: no.
Radiotherapy in pancreatic cancer has a long history of trials that improved local control without moving survival. (when I say long I mean at least: PREOPANC-1 and 2, Alliance A021501, ESPAC-5, PANDAS-PRODIGE 44, CONKO-007, LAP07, SABER… )
MASTERPLAN shows modern SBRT, layered onto mFOLFIRINOX or gem-nab-paclitaxel, more than halves 12m locoregional recurrence without a clear toxicity penalty.
For borderline and locally advanced patients where local failure drives symptoms, this is a strong argument for SBRT in the multidisciplinary plan, but not yet proof it changes survival.”
Title: Perioperative chemotherapy and stereotactic body radiotherapy versus perioperative chemotherapy alone in patients with high-risk, localised pancreatic cancer (MASTERPLAN): an open-label, phase 2, multicentre, randomised trial of the Australasian Gastro-Intestinal Trials Group
Authors: Andrew Oar, Andrew Kneebone, Katrin M. Sjoquist, David Espinoza, Mark Lee, Hien Le, Leily Gholamrezaei, Julie Chu, James Lynam, Girish Mallesara, Dominique Lee, Dinesh Vignarajah, Iain Ward, Jaswinder Samra, Andrew Barbour, Angela Whitehead, Susan Brooks, Anna Nicholson, Tim Wei Wang, Weng Ng, Fathalla Ali, Derrick Siu, Juanita Lopez Gaitan, Olivia Cook, Alisha Moore, Martinus B. Oostendorp, Sonia Yip, John Shakeshaft, David Pryor, Nam Nguyen, and David Goldstein, on behalf of the Australasian Gastro-Intestinal Trials Group (AGITG).
Read the full article.
You may also be interested in: AGITG MASTERPLAN Trial Shows Improved Local Control and Survival With SBRT Plus Chemotherapy in Pancreatic Cancer
