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Induction chemotherapy in pancreatic cancer: CA 19-9 may predict resectability and survival

HPB Aug 03, 2019

Heger U, Sun H, Hinz U, et al. - In unresectable pancreatic cancer (PDAC) preoperative/neoadjuvant treatment (NT) is being used more and more, but about 40% of patients cannot be resected following NT and there is currently a lack of good preoperative reaction assessment, so researchers explored CA 19-9 levels and their dynamics during NT for resectability and survival forecasting. They looked for patients who had exploration or resection following NT with gemcitabine-based therapy (GEM) or FOLFIRINOX (FOL). Out of 318 patients included, 165 underwent resection and 153 had exploration. Independent predictors for resectability in FOL patients were a CA 19-9 < 91.8 U/ml and CA 19-9 ratio of < 0.4 after NT. According to findings, CA 19-9 levels after FOLFIRINOX NT predict PDAC's resectability and survival better than dynamic values and should be included in response assessment and surgical decision-making.

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