MASTERPLAN: A randomised phase II study of Mfolfirinox And STEreotactic Radiotherapy (SBRT) for Pancreatic cancer with high risk and Locally AdvaNced disease

Pancreas cancer (PC) has the fifth highest incidence of cancer related mortality and accounts for the death of more than 3300 Australians annually. For the 80% of PC patients with non-metastatic PC who have high-risk, borderline resectable (BRPC) or locally advanced pancreas cancer (LAPC), the 5-year overall survival is abysmal, at 12%. This is despite having no demonstrable metastatic disease at diagnosis. Approximately half of all PC patients experience locoregional recurrence (LRR). Even with surgery, 40% of patients will experience a LRR in the first 12 months. LRR is a major contributor to the substantial morbidity and mortality of this cancer.

Clinical trials exploring new treatment paradigms for PC including stereotactic body radiotherapy (SBRT), molecular targets and novel biomarkers are recommended within international consensus guidelines. SBRT is a significant dose escalation to standard external beam radiotherapy (EBRT) without an increase in toxicity. This is anticipated to increase tumour cell kill and reduce rates of LRR.  Reduced LRR rates could increase the likelihood of R0 resection allowing the possibility of cure, reduce the debilitating symptoms associated with LRR and progression, and potentially improve overall survival by preventing or delaying development of metastases. MASTERPLAN addresses LRR rates in PC and attempts to improve health outcomes, including overall survival for the nearly 3,300 Australians diagnosed with PC every year.