(HealthDay News) — For patients with borderline resectable/locally advanced (BR/LA) pancreatic ductal adenocarcinoma (PDAC), preoperative FDG-PET may predict pathologic response to neoadjuvant therapy (NAT), according to a study published online Sept. 8 in the Journal of the National Comprehensive Cancer Network.

Amro M. Abdelrahman, MBBS, from the Mayo Clinic in Rochester, Minnesota, and colleagues reviewed 202 patients with resected BR/LA PDAC who underwent NAT with FDG-PET within 60 days of resection to examine the role of preoperative FDG-PET for predicting NAT response and survival.

Post-NAT metabolic (FDG-PET) and biochemical (CA 19-9) responses were compared as preoperative predictors of pathologic response.


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The researchers found that 58% of patients had optimization of CA 19-9 levels post-NAT. Major metabolic responses were seen in 51% of patients, and pathologic responses were seen in 38%. The median recurrence-free survival (RFS) was 21 months, and the median overall survival (OS) was 48.7 months.

Metabolic response was superior to biochemical response in predicting pathologic response, with areas under the curve of 0.86 and 0.75, respectively (P <.001).

In a multivariate analysis, metabolic response was an independent preoperative predictor of pathologic response (odds ratio, 43.2; 95% CI, 16.88–153.16; P <.001), RFS (hazard ratio, 0.37; 95% CI, 0.22–0.6; P <.001), and OS (hazard ratio, 0.21; 95% CI, 0.1–0.42; P <.001).

“With FDG-PET, we can tell patients how the cancer responded to NAT before going through major surgical resection,” Dr Abdelrahman said in a statement.

One author disclosed financial ties to the medical device and biopharmaceutical industries.

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