Multicenter Prospective Cohort Study of Neoadjuvant Chemotherapy for Borderline Resectable Pancreatic Cancer (YPB-001).

IF 1.7 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Pancreas Pub Date : 2024-07-01 Epub Date: 2024-03-04 DOI:10.1097/MPA.0000000000002323

Hiroto Matsui, Tatsuya Ioka, Tsuyoshi Takahashi, Toru Kawaoka, Yoshinari Maeda, Noboru Yahara, Hidefumi Kubo, Taku Nishimura, Toshihiro Inokuchi, Eijiro Harada, Yoshitaro Shindo, Yukio Tokumitsu, Masao Nakajima, Taro Takami, Katsuyoshi Ito, Hidekazu Tanaka, Kimikazu Hamano, Hiroaki Nagano

{"title":"Multicenter Prospective Cohort Study of Neoadjuvant Chemotherapy for Borderline Resectable Pancreatic Cancer (YPB-001).","authors":"Hiroto Matsui, Tatsuya Ioka, Tsuyoshi Takahashi, Toru Kawaoka, Yoshinari Maeda, Noboru Yahara, Hidefumi Kubo, Taku Nishimura, Toshihiro Inokuchi, Eijiro Harada, Yoshitaro Shindo, Yukio Tokumitsu, Masao Nakajima, Taro Takami, Katsuyoshi Ito, Hidekazu Tanaka, Kimikazu Hamano, Hiroaki Nagano","doi":"10.1097/MPA.0000000000002323","DOIUrl":null,"url":null,"abstract":"Objectives: The present multicenter prospective observational study investigated the effectiveness and safety of neoadjuvant chemotherapy (NAC) for patients with borderline resectable pancreatic cancer (BRPC) and those with RPC contacting major vessels, with respect to a historical control of upfront surgery.Materials and methods: Patients with BRPC and RPC contacting major vessels were prospectively registered and administered NAC with durations and regimens determined by the corresponding treating physician. Our primary aim was to assess the R0 resection rate, and secondary aim was to evaluate safety, resection rate, time to treatment failure, overall survival, and response rate.Results: Fifty of 52 enrolled patients were analyzed; 2 with serious comorbidities died during treatment. Thirty-one patients underwent resection, with R0 resection being achieved in 26 (52% of total and 84% of all resected cases). Univariate and multivariate analyses indicated age (≥75 years) as the only independent predictor of nonresection. Median progression-free survival and median survival time were longer in the prospective cohort than in the historical cohort.Conclusions: Overall, NAC for BRPC in real-world setting might yield R0 resection rates similar to those reported in previous clinical studies. Development of safe regimens and management strategies that can maintain treatment intensity in geriatric patients is warranted.","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e501-e512"},"PeriodicalIF":1.7000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pancreas","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/MPA.0000000000002323","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/3/4 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives: The present multicenter prospective observational study investigated the effectiveness and safety of neoadjuvant chemotherapy (NAC) for patients with borderline resectable pancreatic cancer (BRPC) and those with RPC contacting major vessels, with respect to a historical control of upfront surgery.

Materials and methods: Patients with BRPC and RPC contacting major vessels were prospectively registered and administered NAC with durations and regimens determined by the corresponding treating physician. Our primary aim was to assess the R0 resection rate, and secondary aim was to evaluate safety, resection rate, time to treatment failure, overall survival, and response rate.

Results: Fifty of 52 enrolled patients were analyzed; 2 with serious comorbidities died during treatment. Thirty-one patients underwent resection, with R0 resection being achieved in 26 (52% of total and 84% of all resected cases). Univariate and multivariate analyses indicated age (≥75 years) as the only independent predictor of nonresection. Median progression-free survival and median survival time were longer in the prospective cohort than in the historical cohort.

Conclusions: Overall, NAC for BRPC in real-world setting might yield R0 resection rates similar to those reported in previous clinical studies. Development of safe regimens and management strategies that can maintain treatment intensity in geriatric patients is warranted.

查看原文本刊更多论文

边缘可切除胰腺癌新辅助化疗的多中心前瞻性队列研究（YPB-001）。

研究目的本项多中心前瞻性观察研究调查了新辅助化疗（NAC）对边缘可切除胰腺癌（BRPC）患者和接触大血管的RPC患者的有效性和安全性，并对前期手术进行了历史对照：前瞻性登记BRPC和接触大血管的RPC患者，并由相应的主治医生决定给予NAC的疗程和方案。我们的主要目的是评估 R0 切除率，次要目的是评估安全性、切除率、治疗失败时间、总生存期和反应率：对 52 名登记患者中的 50 名患者进行了分析；2 名患有严重并发症的患者在治疗期间死亡。31名患者接受了切除术，其中26人实现了R0切除（占总人数的52%，占所有切除病例的84%）。单变量和多变量分析表明，年龄（≥75 岁）是唯一预测未切除的独立因素。前瞻性队列的中位无进展生存期和中位生存时间均长于历史性队列：总体而言，在现实世界中，NAC 治疗 BRPC 的 R0 切除率可能与之前临床研究报告的结果相似。有必要开发安全的治疗方案和管理策略，以维持老年患者的治疗强度。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Pancreas 医学-胃肠肝病学

CiteScore

4.70

自引率

3.40%

发文量

289

审稿时长

1 months

期刊介绍： Pancreas provides a central forum for communication of original works involving both basic and clinical research on the exocrine and endocrine pancreas and their interrelationships and consequences in disease states. This multidisciplinary, international journal covers the whole spectrum of basic sciences, etiology, prevention, pathophysiology, diagnosis, and surgical and medical management of pancreatic diseases, including cancer.