Pancreatic ductal adenocarcinoma complete regression after preoperative chemotherapy: Surgical results in a small series

• DOI: 10.1016/j.ctarc.2023.100770
• Publication Date: 2023-10-10T18:31:41Z
• Authors: Domenico Pinelli; Andrea Micalef; Barbara Merelli; Rosangela Trezzi; Annalisa Amaduzzi; Stefano Agnesi; Michela Guizzetti; Stefania Camagni; Veronica Fedele; Michele Colledan
• Keywords: Complete pathological response; Disease recurrence; Neoadjuvant therapy; Pancreatic cancer; Neoadjuvant therapy; Neoplasms. Tumors. Oncology. Including cancer and carcinogens; Pancreatic cancer; Complete pathological response; Disease recurrence; RC254-282; 3. Good health

Pancreatic ductal adenocarcinoma (PDAC) becomes a systemic disease from an early stage. Complete surgical resection remains the only validated and potentially curative treatment; disappointingly 20% of patients present with resectable tumour. Although complete pathological regression (pCR) after preoperative chemotherapy could intuitively lead to better outcomes prolonged survival some reports highlighted significant rates recurrence. We describe three cases pCR following for PDAC. The first two received neoadjuvant mFOLFIRINOX PAX-G scheme borderline Recurrence appeared 9 12 months surgery. both started adjuvant therapy straight diagnosis recurrence, rapidly progressed led them death 15 third case was characterized by germline BRCA2 mutation. patient presented PDAC body, intrapancreatic biliary stenosis suspected peritoneal metastasis. One year later, second-line chemotherapy, she underwent explorative laparoscopy total spleno-pancreatectomy without evidence viable tumour cells in specimen. At six is recurrence-free. Very few response pancreatic cancer. observed last years disappointing oncological results. Further investigations are needed predict prognosis chemotherapy.