# LAP07: chemoradiotherapy versus chemotherapy after four months of gemcitabine in locally advanced pancreatic cancer

Source: https://onco.cc/key-papers/paper-lap07-chemoradiotherapy-locally-advanced-pancreatic-hammel-jama-2016/  
OnCo record `paper-lap07-chemoradiotherapy-locally-advanced-pancreatic-hammel-jama-2016` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Adding radiotherapy after four months of chemotherapy did not help people with unresectable, non-metastatic pancreatic cancer live longer, though it delayed local growth; adding erlotinib to gemcitabine did not help either.

## Summary

International open-label phase 3 trial: 449 patients with locally advanced pancreatic cancer were randomised to gemcitabine with or without erlotinib for four months; 269 with controlled disease were then randomised to capecitabine-based chemoradiotherapy or two more months of chemotherapy.

The trial stopped for futility: median overall survival was 16.5 months with chemotherapy and 15.2 months with chemoradiotherapy (hazard ratio 1.03, p 0.83), and 13.6 months with gemcitabine against 11.9 months with gemcitabine plus erlotinib (hazard ratio 1.19). Chemoradiotherapy reduced local progression (32 against 46 percent) with no extra grade 3 to 4 toxicity except nausea.

## Fields

- Kind: Key paper
- Last checked: 2026-09-22
- Journal: JAMA
- Year: 2016
- DOI: 10.1001/jama.2016.4324
- Authors: Hammel P, Huguet F, van Laethem JL, et al.
- Findings: Median overall survival 15.2 months (95% CI 13.9 to 17.3) with chemoradiotherapy versus 16.5 months (14.5 to 18.5) with chemotherapy; hazard ratio 1.03 (0.79 to 1.34).; Gemcitabine 13.6 months versus gemcitabine plus erlotinib 11.9 months; hazard ratio 1.19 (0.97 to 1.45).; Local progression 32 versus 46 percent (p 0.03).
- What it means: Consolidation chemoradiotherapy is optional in locally advanced pancreatic cancer, used for local control rather than survival; erlotinib has no role.
- Caveats: Conventional radiotherapy with capecitabine; modern regimens (FOLFIRINOX induction, stereotactic radiotherapy) were not tested.

## Sources

- JAMA 2016: https://doi.org/10.1001/jama.2016.4324
- PubMed: https://pubmed.ncbi.nlm.nih.gov/27139057/

## Connected records

- cancers: [Locally advanced unresectable pancreatic ductal adenocarcinoma](https://onco.cc/cancers/locally-advanced-pdac/), [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/)
- drugs: [Capecitabine](https://onco.cc/drugs/capecitabine/), [Erlotinib](https://onco.cc/drugs/erlotinib/), [Gemcitabine](https://onco.cc/drugs/gemcitabine/)
- trials: [LAP07](https://onco.cc/trials/lap07/)
- journals: [JAMA](https://onco.cc/journals/jama/)

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