Single-center phase 2 trial of MRI-guided SABR versus CT-guided IRE for locally advanced pancreatic cancer

The randomized phase 2 CROSSFIRE trial at Amsterdam UMC (The Netherlands) compared MRI-guided stereotactic ablative body radiotherapy (SABR) versus CT-guided percutaneous irreversible electroporation (IRE) after FOLFIRINOX chemotherapy for locally advanced pancreatic cancer. The median overall survival from randomization was 16.1 months in the SABR group versus 12.5 months in the IRE group (HR 1.39; p=0.21). Adverse events were seen in 63% of patients in the SABR group versus 59% of the patients in the IRE group (p=0.8); grade 3 or higher AEs in 16% versus 25% (p=0.35); and grade 5 treatment-related adverse events in one patient in each group. The authors conclude that CROSSFIRE did not identify a significant difference in effectivity or safety between MRI-guided SABR and CT-guided IRE after FOLFIRINOX for locally advanced pancreatic cancer.