{"entity":{"id":"paper-lap07-chemoradiotherapy-locally-advanced-pancreatic-hammel-jama-2016","kind":"paper","name":"LAP07: chemoradiotherapy versus chemotherapy after four months of gemcitabine in locally advanced pancreatic cancer","aka":[],"tldr":"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.\n\nThe 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.","asOf":"2026-09-22","links":[{"label":"JAMA 2016","url":"https://doi.org/10.1001/jama.2016.4324"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/27139057/"}],"tags":[],"related":[],"cancers":["locally-advanced-pdac","pancreatic"],"sections":[],"technologies":[],"targets":[],"drugs":["gemcitabine","erlotinib","capecitabine"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["lap07"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["jama"],"dependsOn":[],"notes":[],"journal":"JAMA","year":2016,"doi":"10.1001/jama.2016.4324","pmid":"27139057","authors":"Hammel P, Huguet F, van Laethem JL, et al.","paperType":"rct","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)."],"whatItMeans":"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."],"changedPractice":true,"participants":449},"route":"/key-papers/paper-lap07-chemoradiotherapy-locally-advanced-pancreatic-hammel-jama-2016/","neighbours":{"cancer":[{"id":"locally-advanced-pdac","kind":"cancer","name":"Locally advanced unresectable pancreatic ductal adenocarcinoma","route":"/cancers/locally-advanced-pdac/"},{"id":"pancreatic","kind":"cancer","name":"Pancreatic ductal adenocarcinoma","route":"/cancers/pancreatic/"}],"drug":[{"id":"capecitabine","kind":"drug","name":"Capecitabine","route":"/drugs/capecitabine/"},{"id":"erlotinib","kind":"drug","name":"Erlotinib","route":"/drugs/erlotinib/"},{"id":"gemcitabine","kind":"drug","name":"Gemcitabine","route":"/drugs/gemcitabine/"}],"trial":[{"id":"lap07","kind":"trial","name":"LAP07","route":"/trials/lap07/"}],"journal":[{"id":"jama","kind":"journal","name":"JAMA","route":"/journals/jama/"}]}}