International journal of clinical oncology · 2026
Association between response to gemcitabine-based neoadjuvant therapy and efficacy of gemcitabine plus nab-paclitaxel for recurrent pancreatic ductal adenocarcinoma.
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Kinomoto Takumi, Ikezawa Kenji, Gotoh Kunihito, Kai Yugo, Takada Ryoji, Masumoto Takanori, Kawabata Masaki, Kishimoto Hiroki, Ito Kana, Urabe Makiko, Mukai Kaori, Nakabori Tasuku, Shigekawa Minoru, Akita Hirofumi, Takahashi Hidenori, Kobayashi Shogo, Ohkawa Kazuyoshi
Аннотация
BACKGROUND: Gemcitabine-based neoadjuvant therapy is frequently employed to enable curative resection of pancreatic ductal adenocarcinoma. Gemcitabine plus nab-paclitaxel (GnP) is often given to patients who relapse post-resection, resulting in multiple courses of gemcitabine-containing treatment regimens. However, the effect of prior gemcitabine-based neoadjuvant therapy on the efficacy of GnP therapy remains unclear. This study aimed to determine whether prior gemcitabine-based neoadjuvant therapy affects the therapeutic outcomes of GnP in patients with recurrent pancreatic ductal adenocarcinoma following curative resection.
METHODS: We retrospectively analyzed 51 patients with resectable and borderline resectable pancreatic ductal adenocarcinoma who received gemcitabine-based neoadjuvant chemoradiotherapy, underwent curative-intent surgery, and were treated with GnP post-recurrence. Patients were divided into high-regression (≥ 30% reduction in tumor diameter; 32 patients) and low-regression (< 30%; 19 patients) groups based on the tumor reduction rate during neoadjuvant therapy.
RESULTS: Multivariate analysis identified tumor regression and the time from surgery to recurrence as independent prognostic factors for progression-free survival of GnP therapy following recurrence. Median progression-free survival was significantly longer in the high-regression group (11.8 vs. 5.8 months, p = 0.010). The objective response rate to GnP was significantly higher in the high-regression than low-regression groups (43.8% vs. 10.5%; p = 0.015).
CONCLUSIONS: Patients with greater tumor regression during gemcitabine-based neoadjuvant therapy had better progression-free survival and treatment response to GnP therapy following recurrence. These findings suggest that treatment response to neoadjuvant therapy correlates with post-recurrence outcomes and contributes to the advancement of treatment strategies for recurrent pancreatic ductal adenocarcinoma.
METHODS: We retrospectively analyzed 51 patients with resectable and borderline resectable pancreatic ductal adenocarcinoma who received gemcitabine-based neoadjuvant chemoradiotherapy, underwent curative-intent surgery, and were treated with GnP post-recurrence. Patients were divided into high-regression (≥ 30% reduction in tumor diameter; 32 patients) and low-regression (< 30%; 19 patients) groups based on the tumor reduction rate during neoadjuvant therapy.
RESULTS: Multivariate analysis identified tumor regression and the time from surgery to recurrence as independent prognostic factors for progression-free survival of GnP therapy following recurrence. Median progression-free survival was significantly longer in the high-regression group (11.8 vs. 5.8 months, p = 0.010). The objective response rate to GnP was significantly higher in the high-regression than low-regression groups (43.8% vs. 10.5%; p = 0.015).
CONCLUSIONS: Patients with greater tumor regression during gemcitabine-based neoadjuvant therapy had better progression-free survival and treatment response to GnP therapy following recurrence. These findings suggest that treatment response to neoadjuvant therapy correlates with post-recurrence outcomes and contributes to the advancement of treatment strategies for recurrent pancreatic ductal adenocarcinoma.