Master of Science in Clinical Investigation
First Thesis Advisor
Jennifer LaFemina, MD
pancreatic ductal adenocarcinoma (PDAC), neoadjuvant chemotherapy, stage I/II disease, survival
Background: Pancreatic ductal adenocarcinoma (PDAC) is the third leading cause of US cancer related deaths. This study assessed the oncologic benefit of a neoadjuvant chemotherapy (NAC) treatment strategy for patients with clinical Stage I/II PDAC.
Methods: Patients with biopsy confirmed PDAC and clinical Stage I/II disease were treated with a protocol of NAC. The primary study endpoint was median overall survival (OS). Kaplan-Meier survival curves were compared using the log-rank test.
Results: 56 patients met inclusion criteria. Of these, 21 patients (38%) had Stage I disease and 35 (62%) had Stage II disease. The median OS for the entire study population was 18.7 months. A total of 22 (39%) patients were managed with NAC+S; 34 (61%) received NAC alone. Median OS and 2-year survival rates were greater in those completing NAC+S compared to NAC alone (median OS 28.8 months vs. 17.3 months: p=0.05; 2-year OS: 55% vs 21%: p=0.01) . Interestingly, patients managed with NAC who were not candidates for surgical resection after restaging demonstrated a survival advantage (17.3 months) compared to what was previously reported in historical controls.
Conclusion: NAC+S provided a significant 11.5 month improvement in median OS compared to treatment with NAC alone. Modern NAC may contribute a significant oncologic benefit in the overall treatment strategy for patients with Stage I/II PDAC, even if surgery is not ultimately pursued.
Hendrix, RJ. Improved Survival after Administration of Neoadjuvant Chemotherapy in Patients with Clinical Stage I/II Pancreatic Ductal Adenocarcinoma. (2019). University of Massachusetts Medical School. GSBS Dissertations and Theses. Paper 1029. DOI: 10.13028/9qvz-4h07. https://escholarship.umassmed.edu/gsbs_diss/1029
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Available for download on Wednesday, June 02, 2021