Factors associated with favourable pathological tumour response after neoadjuvant chemotherapy in patients with pancreatic ductal adenocarcinoma
Halle-Smith, James M Leung, Prudence Hall, Lewis Aksin, Merve van Laarhoven, Stijn Skipworth, James Chatzizacharias, Nikolaos Brown, Rachel M Roberts, Keith J
Halle-Smith, James M
Leung, Prudence
Hall, Lewis
Aksin, Merve
van Laarhoven, Stijn
Skipworth, James
Chatzizacharias, Nikolaos
Brown, Rachel M
Roberts, Keith J
Affiliation
University Hospitals Birmingham NHS Foundation Trust; University of Birmingham; Aston University; University Hospitals Bristol and Weston NHS Foundation Trust;
Other Contributors
Publication date
2024-09-11
Subject
Collections
Research Projects
Organizational Units
Journal Issue
Abstract
Introduction: Pathological response of pancreatic ductal adenocarcinoma (PDAC) to neoadjuvant chemotherapy (NAT) has been associated with oncological outcome. The aim of the study was to investigate factors associated with favourable tumour regression in patients undergoing pancreatic resection for PDAC.
Methods: Patients who received NAT before undergoing PDAC resection at two institutions were reviewed. Tumour regression grading (TRG) was scored according to the College of American Pathologists (CAP) system. Interactions between chemotherapy, tumour and surgical factors with TRG were explored.
Results: 54 patients were identified, with 12 (22%) displaying a favourable response to NAT. The type of chemotherapy agent received, the number of cycles or a dose reduction during NAT course was not significantly different between the groups. The time from diagnosis to chemotherapy and time from end of chemotherapy to surgery were also similar between the groups. A favourable TRG was associated with greater disease-free survival median 33.2 months vs. 10.3 months; p = 0.0) but not overall survival (median 43.8 months vs. 32.3 months; p = 0.200), which may be due to small sample size.
Conclusions: Chemotherapy factors were not significantly related to a favourable response to NAT. Future studies should seek to identify modifiable factors associated with a favourable TRG.
Citation
Halle-Smith JM, Leung P, Hall L, Aksin M, van Laarhoven S, Skipworth J, Chatzizacharias N, Brown RM, Roberts KJ. Factors associated with favourable pathological tumour response after neoadjuvant chemotherapy in patients with pancreatic ductal adenocarcinoma. HPB (Oxford). 2024 Dec;26(12):1536-1543. doi: 10.1016/j.hpb.2024.09.002. Epub 2024 Sep 12.
Type
Article