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. 2021 Mar;41(3):1629-1639.
doi: 10.21873/anticanres.14925.

Efficacy of Adjuvant Chemotherapy According to the Pathological Response to Neoadjuvant Chemotherapy Among Patients With Pancreatic Ductal Adenocarcinoma

Shozo Mori  1 , Taku Aoki  2 , Yuhki Sakuraoka  2 , Takayuki Shimizu  2 , Takamune Yamaguchi  2 , Kyung-Hwa Park  2 , Takatsugu Matsumoto  2 , Takayuki Shiraki  2 , Yukihiro Iso  2 , Keiichi Kubota  2
Affiliations

Efficacy of Adjuvant Chemotherapy According to the Pathological Response to Neoadjuvant Chemotherapy Among Patients With Pancreatic Ductal Adenocarcinoma

Shozo Mori et al. Anticancer Res. 2021 Mar.

Abstract

Background/aim: An association between the pathological response to neoadjuvant chemotherapy (NAC) and the efficacy of adjuvant chemotherapy (AC) in patients with pancreatic ductal adenocarcinoma (PDAC) remains unknown.

Patients and methods: A total of 121 patients with PDAC who underwent a pancreatectomy between January 2013 and March 2020 were divided into two groups: an upfront surgery (UFS) group (n=42), and an NAC (gemcitabine plus S-1) group (n=79). In the NAC group, the pathological response was evaluated using the Evans classification.

Results: The overall survival was significantly higher in patients with an AC relative dose intensity (RDI) ≥80% than in patients with an AC RDI <80% in the UFS, NAC-Evans IIa, and NAC-Evans IIb+III groups. However, this difference was not observed in the NAC-Evans I group.

Conclusion: AC is preferable for patients with NAC-Evans IIa or IIb+III, but more effective AC regimens may be needed for NAC-Evans I patients.

Keywords: Pancreatic cancer; S-1; chemotherapy; gemcitabine; relative dose intensity.

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