Research led by the University of Colorado Cancer Center and Amsterdam University Medical Center provides an in-depth analysis of pathological complete response and its impact on overall survival.

A new study published today in JAMA Network Open by an international cohort of researchers provides the latest data on the effectiveness of treating pancreatic adenocarcinoma (hereafter: pancreatic cancer) patients with chemotherapy (with or without radiation therapy) before surgery to remove a tumor.

This retrospective international multicenter study including 1758 patients from 19 centers (8 countries and 3 continents) was leaded by prof. dr. Marco Del Chiaro (University of Colorado) and prof. dr. Marc Besselink (Amsterdam UMC), coordinated by drs. Thomas Stoop (Amsterdam UMC & University of Colorado), dr. Atsushi Oba (Japanese Foundation for Cancer Research & University of Colorado), and drs. Andrew Wu (Johns Hopkins University & University of Colorado).

The present study found that after preoperative chemotherapy (with or without radiotherapy) followed by surgery surgery, nearly 4.8% of patients had no detectable cancer cells left in the removed pancreatic tissue, achieving a pathological complete response (pCR).

“PCR means that the cancer has responded extremely well to the treatment, leaving no evidence of cancer in the area examined. Although pCR does not mean someone is cured, patients who have pCR tend to live longer, with a doubled 5-year overall survival (63% versus 20%) and a three-fold 5-year recurrence-free survival (64% versus 20%). These results are helpful to inform patients after surgery, providing information on their prognosis.

“This increase is a big deal for a disease like pancreatic cancer where progress and treatments have gradually improved over the years but is still much lower than other cancers,” adds Del Chiaro.

The paper also goes into detail about the factors that contribute to pCR, revealing several factors associated with achieving pCR, including the specific chemotherapy regimens and radiotherapy modalities used before surgery, and the disease characteristics including radiological disease response and normal(ized) serum tumor marker CA19-9.

“Our ultimate goal is to improve the selection of treatment for patients and enhance prognostic accuracy. We hope this research paper can help oncologists understand the predictors that make patients more likely to achieve pCR, and improve survival, including the biological factors that make a tumor more favorable for surgery,” said first author Thomas Stoop, MD, who works at the Amsterdam University Medical Center and former research fellow at the CU Anschutz Medical Campus in the field of pancreatic cancer surgery.

Thomas Stoop, MD, PhD candidate HPB Surgery Amsterdam UMC

The findings suggest that tailoring treatment based on these factors could be beneficial. However, they note that these factors might only apply to some patients uniformly. For instance, while one treatment method (SBRT) was associated with achieving pCR, it was not associated with increase in overall survival rate. This highlights the complexity of treatment decisions and the need for further research to validate these findings and understand their broader applicability across different patient populations.

“Although there are a lot of complexities in understanding and improving treatments for pancreatic cancer, I’m hopeful for the future and this study is part of the reason why. Researchers working together worldwide to provide more in-depth data strengthens our ability as doctors and researchers to provide better treatment plans and breakthroughs to help our patients,” said Del Chiaro.

See the original article here: New Global Research Aims to Improve Survival Rates for Pancreatic Cancer Patients (cuanschutz.edu)

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