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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.
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.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
68 randomised.
95% CI 12.1 to 19.4 · 95% CI 10.9 to 17.0
Source| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Overall survival from randomisationprimary | MRI-guided SABR (5 x 8 Gy) | 34 | 16.1 months | 1.39 (0.84 to 2.3) | 0.21 | link |
| CT-guided percutaneous irreversible electroporation | 34 | 12.5 months |
Shares LAP07, Locally advanced unresectable pancreatic ductal adenocarcinoma, Pancreatic ductal adenocarcinoma.
Shares Cholangitis: infection of a blocked bile duct, FOLFIRINOX / mFOLFIRINOX, Locally advanced unresectable pancreatic ductal adenocarcinoma, Pancreatic ductal adenocarcinoma.
Shares Irreversible electroporation (NanoKnife), Locally advanced unresectable pancreatic ductal adenocarcinoma, Pancreatic ductal adenocarcinoma.
Shares LAP07, FOLFIRINOX / mFOLFIRINOX, Locally advanced unresectable pancreatic ductal adenocarcinoma, Pancreatic ductal adenocarcinoma.
Shares Irreversible electroporation (NanoKnife), Locally advanced unresectable pancreatic ductal adenocarcinoma.
Shares LAP07, Locally advanced unresectable pancreatic ductal adenocarcinoma, Pancreatic ductal adenocarcinoma.
Shares Irreversible electroporation (NanoKnife), Locally advanced unresectable pancreatic ductal adenocarcinoma.
Shares Locally advanced unresectable pancreatic ductal adenocarcinoma, SBRT / SABR (stereotactic radiotherapy), Pancreatic ductal adenocarcinoma.