Circulating Tumor Cells Dynamics in Pancreatic Adenocarcinoma Correlate With Disease Status

Gemenetzis, Georgios; Groot, Vincent P.; Yu, Jun; Ding, Ding; Teinor, Jonathan A.; Javed, Ammar A.; Wood, Laura D.; Burkhart, Richard A.; Cameron, John L.; Makary, Martin A.; Weiss, Matthew J.; He, Jin; Wolfgang, Christopher L.

doi:10.1097/sla.0000000000002925

Cited by 130 publications

(106 citation statements)

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“…37 NAT appears to reduce the circulating tumor cell burden, with a preventive effect on early recurrence. 38 The association between splenic vessel involvement and portal vein circulating tumor cells has not been established yet, and further research is needed to determine its impact on overall survival. Nonetheless, the significance of radiographic splenic vessel involvement is currently not contemplated by the centers participating in the current study, as it was not a significant selection criterion for NAT in the multivariable analysis.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of Neoadjuvant Therapy in Resected Pancreatic Ductal Adenocarcinoma of the Pancreatic Body or Tail on Surgical and Oncological Outcome: A Propensity-Score Matched Multicenter Study

et al. 2019

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Background. Several studies have suggested a survival benefit of neoadjuvant therapy (NAT) for pancreatic ductal adenocarcinoma (PDAC) in the pancreatic head. Data concerning NAT for PDAC located in pancreatic body or tail are lacking. Methods. Post hoc analysis of an international multicenter retrospective cohort of distal pancreatectomy for PDAC in 34 centers from 11 countries (2007-2015). Patients who underwent resection after NAT were matched (1:1 ratio), using propensity scores based on baseline characteristics, to patients who underwent upfront resection. Median overall survival was compared using the stratified log-rank test. Results. Among 1236 patients, 136 (11.0%) received NAT, most frequently FOLFIRINOX (25.7%). In total, 94 patients receiving NAT were matched to 94 patients undergoing upfront resection. NAT was associated with less postoperative major morbidity (Clavien-Dindo C 3a, 10.6% vs. 23.4%, P = 0.020) and pancreatic fistula grade B/C (9.6% vs. 21.3%, P = 0.026). NAT did not improve overall survival [27 (95% CI 14-39) versus 31 months (95% CI 19-42), P = 0.277], as compared with upfront resection. In a sensitivity analysis of 251 patients with radiographic tumor involvement of splenic vessels, NAT Mohammed Abu Hilal and Marc G. Besselink share senior authorship.

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Section: Discussionmentioning

confidence: 99%

“…(n = 37, 14.7%) was associated with prolonged overall survival [36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53]) versus 20 months (95% CI [15][16][17][18][19][20][21][22][23][24], P = 0.049], as compared with upfront resection. Conclusion.…”

mentioning

confidence: 99%

Impact of Neoadjuvant Therapy in Resected Pancreatic Ductal Adenocarcinoma of the Pancreatic Body or Tail on Surgical and Oncological Outcome: A Propensity-Score Matched Multicenter Study

et al. 2019

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“…Notably, new alterations in CTCs were even identified long before disease recurrence, indicating that CTC can be used as a predictive marker to anticipate the relapse and establish new therapeutic strategies. CTCs, despite their relative rarity, were isolated in blood from PDAC patients (review in Martini et al, 2019) prior and even after therapy using various standard methods such as CellSearch ® [ 96 ], ScreenCell ® system [ 97 , 98 , 99 , 100 ], anti-cytokeratin/anti-EpCam MACS enrichment [ 101 ], isolation by size of epithelial tumor (ISET) cells assay [ 102 ], and microfluid platform [ 103 ]. In PDAC patients, CTCs were shown to be heterogenous [ 104 ].…”

Section: Pdac Organoids and Personalized Medicinementioning

confidence: 99%

“…In PDAC patients, CTCs were shown to be heterogenous [ 104 ]. A first study identified two CTC subtypes: The “ epithelial ” CTCs (eCTCs) and the “ epithelial/mesenchymal ” CTCs (mCTCs) [ 102 ]. A recent study classified PDAC CTCs in 3 categories “epithelial”, “mesenchymal”, and “hybrid”, based on E-cadherin and vimentin expression [ 105 ].…”

Section: Pdac Organoids and Personalized Medicinementioning

confidence: 99%

Pancreatic Ductal Adenocarcinoma (PDAC) Organoids: The Shining Light at the End of the Tunnel for Drug Response Prediction and Personalized Medicine

Frappart

Hofmann

2020

Cancers

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Pancreatic ductal adenocarcinoma (PDAC) represents 90% of pancreatic malignancies. In contrast to many other tumor entities, the prognosis of PDAC has not significantly improved during the past thirty years. Patients are often diagnosed too late, leading to an overall five-year survival rate below 10%. More dramatically, PDAC cases are on the rise and it is expected to become the second leading cause of death by cancer in western countries by 2030. Currently, the use of gemcitabine/nab-paclitaxel or FOLFIRINOX remains the standard chemotherapy treatment but still with limited efficiency. There is an urgent need for the development of early diagnostic and therapeutic tools. To this point, in the past 5 years, organoid technology has emerged as a revolution in the field of PDAC personalized medicine. Here, we are reviewing and discussing the current technical and scientific knowledge on PDAC organoids, their future perspectives, and how they can represent a game change in the fight against PDAC by improving both diagnosis and treatment options.

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“…Circulating tumor cells (CTCs) fluctuations were also reported to be used to monitor disease progression and clinical response to therapy in patients with PDAC (62,63). A recent study by the Johns Hopkins University found a significantly lower number of total CTCs in patients who received preoperative chemotherapy, compared to patients who did not and preoperative number of CTCs was the only predictor of early recurrence within 12 months from surgery.…”

Section: Future Perspectives: Bio-imaging and Bio-markersmentioning

confidence: 99%

Response to Preoperative Therapy in Localized Pancreatic Cancer

2020

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Evaluation of response to preoperative therapy for patients with pancreatic adenocarcinoma has been historically difficult. Therefore, preoperative regimens have generally been selected on the basis of baseline data such as radiographic stage and serum CA 19-9 level and then typically administered for a pre-specified duration as long as 6 months or more. The decision to proceed with resection following preoperative therapy likewise has rested upon the absence of disease progression rather than evidence for tumor response. This article reviews the basis for the evaluation of therapeutic response after preoperative therapy for pancreatic cancer in the existing scientific literature, and providing updates and new perspectives.

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Circulating Tumor Cells Dynamics in Pancreatic Adenocarcinoma Correlate With Disease Status

Abstract: We report novel findings regarding CTCs from a large prospective cohort of PDAC patients. CTCs dynamics reflect progression of disease and response to treatment, providing important information on clinical outcomes, not available by current tumor markers and imaging.

Cited by 130 publications

References 50 publications

Impact of Neoadjuvant Therapy in Resected Pancreatic Ductal Adenocarcinoma of the Pancreatic Body or Tail on Surgical and Oncological Outcome: A Propensity-Score Matched Multicenter Study

Impact of Neoadjuvant Therapy in Resected Pancreatic Ductal Adenocarcinoma of the Pancreatic Body or Tail on Surgical and Oncological Outcome: A Propensity-Score Matched Multicenter Study

Pancreatic Ductal Adenocarcinoma (PDAC) Organoids: The Shining Light at the End of the Tunnel for Drug Response Prediction and Personalized Medicine

Response to Preoperative Therapy in Localized Pancreatic Cancer

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