# CROSSFIRE

Source: https://onco.cc/trials/crossfire/  
OnCo record `crossfire` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

CROSSFIRE is the only randomised comparison of the two local treatments offered after chemotherapy for pancreatic cancer that cannot be removed, MR-guided stereotactic radiotherapy and irreversible electroporation; survival was 16.1 against 12.5 months with no significant difference, the trial stopped early for futility, and neither has been shown to beat chemotherapy alone.

## Summary

CROSSFIRE randomised 68 patients between May 2016 and March 2022 (34 to SABR, 34 to irreversible electroporation). Median overall survival from randomisation was 16.1 months (95 percent confidence interval 12.1 to 19.4) with SABR against 12.5 months (10.9 to 17.0) with electroporation (hazard ratio 1.39, 0.84 to 2.30; p 0.21); the conditional probability of showing superiority of either technique was 0.13 and accrual stopped. Adverse events occurred in 63 against 59 percent, grade 3 to 5 in 16 against 25 percent (cholangitis, abdominal pain and pancreatitis the commonest), with one treatment-related death in each arm. The authors asked future trials to test local ablation against chemotherapy alone; the corpus's locally advanced row cites it beside PANFIRE-2 (single-arm electroporation, 17 months from diagnosis) and LAP07.

## Fields

- Kind: Trial
- Status: negative
- Last checked: 2026-09-24
- Also known as: CROSSFIRE trial
- Registry id: NCT02791503
- Phase: 2
- Setting: Stage III locally advanced pancreatic cancer of 5 cm or less after three to eight cycles of FOLFIRINOX at a single Dutch centre: MRI-guided stereotactic ablative radiotherapy (five fractions of 8 Gy) against CT-guided percutaneous irreversible electroporation, with overall survival from randomisation as the primary endpoint
- Sponsor: Amsterdam University Medical Centre (M. R. Meijerink), with the Adessium Foundation and AngioDynamics
- Enrolled: 68
- Result: Median overall survival 16.1 months with MRI-guided stereotactic ablative radiotherapy against 12.5 months with irreversible electroporation (hazard ratio 1.39, 95 percent confidence interval 0.84 to 2.30; p 0.21); stopped for futility.
- Outcomes: Overall survival from randomisation: MRI-guided SABR (5 x 8 Gy) 16.1 months vs CT-guided percutaneous irreversible electroporation 12.5 months, HR 1.39

## Sources

- ClinicalTrials.gov NCT02791503: https://clinicaltrials.gov/study/NCT02791503
- Timmer et al., CROSSFIRE (Lancet Gastroenterology and Hepatology 2024): https://doi.org/10.1016/S2468-1253(24)00017-7

## Connected records

- cancers: [Locally advanced unresectable pancreatic ductal adenocarcinoma](https://onco.cc/cancers/locally-advanced-pdac/), [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/)
- technologies: [Irreversible electroporation (NanoKnife)](https://onco.cc/technologies/irreversible-electroporation/), [MR-guided adaptive radiotherapy](https://onco.cc/technologies/mr-linac/), [SBRT / SABR (stereotactic radiotherapy)](https://onco.cc/technologies/sbrt/)
- drugs: [FOLFIRINOX / mFOLFIRINOX](https://onco.cc/drugs/folfirinox/)
- terms: [Cholangitis: infection of a blocked bile duct](https://onco.cc/terms/acute-cholangitis/)
- trials: [LAP07](https://onco.cc/trials/lap07/), [PANFIRE-2](https://onco.cc/trials/panfire-2/)

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