Adjuvant chemotherapy improves overall survival for pancreatic cancer patients: JAMA Oncology study

Cancer that develops in pancreatic cells is known as pancreatic cancer. The pancreas is an organ in your abdomen that is located behind the bottom portion of your stomach. Pancreatic cancer starts in the tissues of the pancreas. Your pancreas generates hormones that help you control your blood sugar as well as enzymes that help with digestion.

University of Colorado Cancer Center recently released new research that showcases chemotherapy treatment before and after surgery for pancreatic cancer as the most effective combination for patients.

The study findings were published in JAMA Oncology and led by Marco Del Chiaro, MD, division chief of surgical oncology in the University of Colorado Department of Surgery, and visiting researcher Toshitaka Sugawara, MD, PhD.

"It's critical to have large-scale data that doctors can use to make decisions about chemotherapy plans for patients who qualify for pancreatic cancer surgery," said author Marco Del Chiaro, MD, division chief of surgical oncology at the CU Cancer Center on the University of Colorado Anschutz Medical Campus.

The study showed overall survival was significantly longer in patients who received adjuvant chemotherapy after neo-adjuvant chemotherapy followed by surgery, compared to the group of patients that did not receive it.

This was the case for all patients independent of their lymph node status and resection margins.

"The success of adjuvant chemotherapy used to be unclear, with varied data available for doctors to consider. Our study suggests that adjuvant chemotherapy after surgery should be implemented no matter the biological stage of the cancer," adds Del Chiaro.

The researchers conducted a nationwide, retrospective study examining the overall survival of patients who received adjuvant chemotherapy and those who did not. To do so, they used data from the National Cancer Database and included nearly 900 patients with pancreatic adenocarcinoma (PDAC) diagnosed between 2010 to 2018.

They found adjuvant chemotherapy was associated with better survival in patients with any pathological N stage and margin status.

"It's important to continue to move forward research in pancreatic cancer care to improve the survival rate. By conducting the largest study of its kind and analyzing data using multiple models, we're able to improve the knowledge in this paper for doctors and patients to inform their plans and help prolong survival in many cases," said lead researcher Sugawara.

Sugawara and his team investigated the interactions between pathological findings and adjuvant chemotherapy in separate multivariable Cox regression models. Their findings suggest that tumors with aggressive biology benefit from adjuvant chemotherapy even after surgery.

Reference:

Marco Del Chiaro et al,Association of Adjuvant Chemotherapy in Patients With Resected Pancreatic Adenocarcinoma After Multiagent Neoadjuvant Chemotherapy, JAMA Oncology, DOI 10.1001/jamaoncol.2022.5808