- In patients with borderline resectable pancreatic cancer, neoadjuvant therapy with gemcitabine plus nab-paclitaxel (GnP) is associated with a higher R0 resection rate and better OS than upfront surgery.
Why this matters
- GnP neoadjuvant therapy was previously shown to reduce tumor size in nonresectable pancreatic cancer.
- Retrospective analysis of 31 patients who underwent GnP neoadjuvant therapy and 26 patients who underwent upfront surgery.
- Funding: Grants-in-Aid for Scientific Research.
- Median number of GnP cycles, 3 (range, 1-10).
- Median change in tumor size with GnP, −23.3% (range, −51.4% to 28.0%).
- Surgery outcomes, GnP vs upfront surgery:
- R0 surgery, 100% vs 77% (P=.0100).
- Lymph node metastases present at surgery, 67% vs 88% (P=.0581).
- Median operation time, 429 vs 509.5 minutes (P=.0068).
- Surgery blood loss, 760 vs 1324 mL (P=.0115).
- Intermediate outcomes, GnP vs upfront surgery:
- Recurrence frequency, 33% vs 77%.
- Median disease-free survival (DFS), 633 vs 170 days.
- Median 2-year DFS, 35.6% vs 16.4% (P=.0018).
- Median OS, 838 vs 373 days.
- Median 2-year OS, 73.0% vs 25.0% (P=.0024).
- Retrospective analysis.
- Small study population.
- Study conducted in Japan.