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SWOG S1505 gave people with operable pancreatic cancer three months of chemotherapy before and after surgery with one of the two modern regimens; about half were alive at two years with either, no better than the 40 percent threshold the trial set from adjuvant-only history, and a third of the patients enrolled turned out not to have resectable tumours on central review.
S1505 enrolled 147 patients between 2015 and 2018; 43 (29 percent) were ineligible at central radiology review because their disease exceeded resectability criteria, leaving 102 evaluable patients (55 on modified FOLFIRINOX, 47 on gemcitabine plus nab-paclitaxel). In each arm 84 to 85 percent completed preoperative chemotherapy, 73 and 70 percent underwent resection and 49 and 40 percent completed all treatment. Two-year overall survival was 47 percent (95 percent confidence interval 31 to 61) with modified FOLFIRINOX and 48 percent (31 to 63) with gemcitabine plus nab-paclitaxel, median overall survival 23.2 and 23.6 months, and neither arm's estimate exceeded the a priori 40 percent threshold; median disease-free survival after resection was 10.9 and 14.2 months. The trial showed perioperative chemotherapy is deliverable with high resection rates but did not show it improves survival over adjuvant treatment, and it exposed how often local teams over-call resectability, a quality-control problem carried into Alliance A021806.
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.
147 enrolled.
95% CI 31 to 61 · 95% CI 31 to 63
Source| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Overall survival at 2 years (eligible patients)primary | Perioperative mFOLFIRINOX | 55 | 47% | - | - | link |
| Perioperative gemcitabine + nab-paclitaxel | 47 | 48% |
Shares NORPACT-1, Gemcitabine + nab-paclitaxel, Nab-paclitaxel, Neoadjuvant / adjuvant / perioperative.
Shares Alliance A021806, NORPACT-1, FOLFIRINOX / mFOLFIRINOX, Neoadjuvant / adjuvant / perioperative.
Shares Resectable, borderline resectable and unresectable, Gemcitabine + nab-paclitaxel, FOLFIRINOX / mFOLFIRINOX, Nab-paclitaxel.
Shares NORPACT-1, Resectable, borderline resectable and unresectable, FOLFIRINOX / mFOLFIRINOX, Neoadjuvant / adjuvant / perioperative.
Shares NORPACT-1, FOLFIRINOX / mFOLFIRINOX, Resectable pancreatic ductal adenocarcinoma, Pancreatic ductal adenocarcinoma.
Shares Gemcitabine + nab-paclitaxel, Nab-paclitaxel, Resectable pancreatic ductal adenocarcinoma, Cytotoxic chemotherapy.
Shares Gemcitabine + nab-paclitaxel, FOLFIRINOX / mFOLFIRINOX, Resectable pancreatic ductal adenocarcinoma, Cytotoxic chemotherapy.
Shares Resectable, borderline resectable and unresectable, FOLFIRINOX / mFOLFIRINOX, Neoadjuvant / adjuvant / perioperative, Cytotoxic chemotherapy.