- Adjuvant chemotherapy is associated with better outcomes in resected pancreatic ductal adenocarcinoma (PDAC) treated with neoadjuvant therapy.
Why this matters
- National guidelines suggest consideration of adjuvant therapy in patients who have undergone neoadjuvant therapy, but no high-level data support this position.
- Propensity-score matched analysis (n=245; 63% adjuvant chemotherapy).
- Funding: NIH.
- Compared with the no-adjuvant therapy group, the adjuvant chemotherapy group:
- Underwent fewer cycles of neoadjuvant chemotherapy (median, 3 vs 4; P<.01>
- More often received only (chemo)radiotherapy (46% vs 21%; P<.01>
- Had a higher median CA 19-9 level before surgery (32 vs 24 U/mL; P=.03); and
- Had a larger median tumor diameter (2.8 vs 2.4 cm; P=.01).
- Median OS trended toward being higher in the adjuvant chemotherapy group: 42 vs 32 months; P=.06 (HR, 0.55; P=.05).
- Median recurrence-free survival was longer in the adjuvant chemotherapy group: 17 vs 12 months; P=.04 (HR, 0.53; P=.038).
- Retrospective analysis.