{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T04:19:43Z","timestamp":1792815583373,"version":"4.5.0"},"reference-count":30,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"30","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["J Clin Oncol"],"published-print":{"date-parts":[[2025,10,20]]},"abstract":"\n PURPOSE<\/jats:title>\n To determine the benefit, measured as complete removal of a tumor so that no tumor cells are detectable during histopathologic examination of the resection margin (R0 resection rate), of induction chemotherapy plus chemoradiotherapy (CRT) compared with chemotherapy alone for unresectable pancreatic tumors.<\/jats:p>\n <\/jats:sec>\n \n PATIENTS AND METHODS<\/jats:title>\n CONKO-007, an investigator-initiated open-label, multicentric, phase III randomized clinical trial, enrolled 525 patients with unresectable tumors, and 495 patients received induction chemotherapy (402 with fluorouracil, irinotecan, and oxaliplatin [FOLFIRINOX] and 93 with gemcitabine). Patients without progression after 3 months of induction chemotherapy (n = 336) were randomly assigned for continuation of the same chemotherapy (n = 167) or CRT (n = 169; 50.4Gy concurrently with gemcitabine). Resectability was centrally reassessed by a panel of surgeons. Surgery was recommended if possible. After an interim analysis, the primary end point was changed from overall survival (OS) to overall R0 resection rate because of slow recruitment. The median follow-up was 76 months. Important planned secondary end points were R0 resection rate in the surgically treated population and OS.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n \n The primary end point (overall R0 resection rate) was not significantly different between treatment arms with 25% (43 of 169) in the CRT arm versus 18% in the chemotherapy arm (30 of 167;\n P<\/jats:italic>\n = .113). Secondary end point analysis showed that surgery was performed equally often (\n P<\/jats:italic>\n = .91); R0 resection rate in patients who underwent surgery was higher after CRT, 69.4% (43 of 62) compared with chemotherapy alone: 50.0% (30 of 60 patients,\n P<\/jats:italic>\n = .04). Other parameters of resection (ratio of R0\/R1\/R2\/no resection) also favored CRT (\n P<\/jats:italic>\n = .02). No difference in OS was seen between treatment arms (hazard ratio [HR], 0.937 [95% CI, 0.747 to 1.174];\n P<\/jats:italic>\n = .57; randomly assigned intention-to-treat patients). Surgery was associated with longer OS (\n P<\/jats:italic>\n < .001, HR, 0.525 [95% CI, 0.408 to 0.676]).\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSION<\/jats:title>\n Although not improving overall R0 resection rate or survival, CRT enables a R0 resection in surgically treated patients more often than chemotherapy alone.<\/jats:p>\n <\/jats:sec>","DOI":"10.1200\/jco-24-01502","type":"journal-article","created":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T19:59:09Z","timestamp":1755115149000},"page":"3266-3278","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":45,"title":["Benefit of Chemoradiotherapy Versus Chemotherapy After Induction Therapy for Conversion of Unresectable Into Resectable Pancreatic Cancer: The Randomized CONKO-007 Trial"],"prefix":"10.1200","volume":"43","clinical-trial-number":[{"clinical-trial-number":"nct01827553","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8295-7145","authenticated-orcid":true,"given":"Rainer","family":"Fietkau","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg (FAU), Erlangen, Germany"},{"name":"Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany"},{"name":"National Center for Tumor Diseases (NCT), NCT WERA, a partnership between DKFZ, and the universities and university hospitals in W\u00fcrzburg, Erlangen, Regensburg and Augsburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8208-1526","authenticated-orcid":true,"given":"Michael","family":"Ghadimi","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Pediatric Surgery, Medical Center, Georg-August-University G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Gr\u00fctzmann","sequence":"additional","affiliation":[{"name":"Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany"},{"name":"National Center for Tumor Diseases (NCT), NCT WERA, a partnership between DKFZ, and the universities and university hospitals in W\u00fcrzburg, Erlangen, Regensburg and Augsburg, Germany"},{"name":"Department of Surgery, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg (FAU), Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uwe A.","family":"Wittel","sequence":"additional","affiliation":[{"name":"Department for General- and Visceral Surgery, Medical Center and Faculty of Medicine, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lutz","family":"Jacobasch","sequence":"additional","affiliation":[{"name":"Private Practice of Hematology and Medical Oncology, Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waldemar","family":"Uhl","sequence":"additional","affiliation":[{"name":"Department of Surgery, St Josef Hospital, Ruhr-University Bochum, Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland S.","family":"Croner","sequence":"additional","affiliation":[{"name":"Department of General-, Vascular-, Visceral- and Transplant Surgery, University Hospital Magdeburg, Magdeburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3267-8145","authenticated-orcid":true,"given":"Wolf Otto","family":"Bechstein","sequence":"additional","affiliation":[{"name":"Department of General and Visceral Surgery, Frankfurt University Hospital and Clinics, Frankfurt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3831-8917","authenticated-orcid":true,"given":"Ulf Peter","family":"Neumann","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Hospital RWTH Aachen, Aachen, Germany"},{"name":"Department of Surgery, University of Essen, Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Waldschmidt","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Hospital Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1922-2127","authenticated-orcid":true,"given":"Stefan","family":"Boeck","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology and Comprehensive Cancer Centre, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Munich, Germany"},{"name":"Department of Hematology and Oncology, M\u00fcnchen Klinik Neuperlach, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Moosmann","sequence":"additional","affiliation":[{"name":"National Center for Tumor Diseases (NCT), NCT WERA, a partnership between DKFZ, and the universities and university hospitals in W\u00fcrzburg, Erlangen, Regensburg and Augsburg, Germany"},{"name":"Department of Medical Oncology and Hematology, Krankenhaus Barmherzige Br\u00fcder Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7838-6877","authenticated-orcid":true,"given":"Anke C.","family":"Reinacher-Schick","sequence":"additional","affiliation":[{"name":"Department for Hematology, Oncology and Palliative Care, St Josef-Hospital, Ruhr-University Bochum, Bochum, 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