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Effect of neoadjuvant treatment

In approximately 80% of patients with pancreatic cancer, the disease is too advanced to be surgically resected.

Of the 20% of patients, who do have resectable disease and undergo surgery, about one fifth will develop distant metastasis within three months. Furthermore, about 50-60% of patients who underwent surgery cannot receive adjuvant treatment due to e.g. major postoperative complications and therefore lose the survival benefit associated with completed adjuvant therapy.

About the project

Neoadjuvant treatment of patients with primary resectable pancreatic cancer aims at preventing distant cancer spread and secures systemic treatment, irrespective of the patient’s eligibility for adjuvant chemotherapy.

NorPACT-1 is a multicenter randomized controlled trial that compares upfront surgery followed by adjuvant chemotherapy with neoadjuvant chemotherapy followed by surgery (link). The current project analyzes the surgical resection specimens of patients enrolled in the trial arm with neoadjuvant treatment.

Patterns of tumour regression are analysed, and the suitability of currently existing tumour regression grading systems is examined. Morphological intratumour heterogeneity is investigated in the residual viable tumour tissue, and distinct tumour subpopulations are compared in terms of proliferation and expression of markers for chemosensitivity, cancer stem cells, epithelial-mesenchymal transition and distant metastasis.

The project is part of a tripartite study “Neoadjuvant treatment for pancreatic cancer: towards improved patient selection and assessment of treatment effect”. (In Norwegian) 

Collaborators 

  • Knut Jørgen Labori, Oslo University Hospital, Norway
  • Elin Kure, Oslo University Hospital, Norway
  • Matthias Löhr, CLINTEC, Karolinska Institute, Sweden
  • Jérôme Cros, Dept of Pathology, Hôpital Beaujon, Paris, France

Funding

  • South-Eastern Norway Regional Health Authority (HSØ), project nr. 2016090

Study period

  • 2016 - 2020

Contact

Published Apr. 4, 2019 12:41 PM - Last modified May 8, 2019 9:45 AM