CT could predict chemo effectiveness in patients with pancreatic cancer

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Routine CT scans that are performed to guide the treatment of pancreatic cancer could predict its effectiveness, according to a study published on Mar. 10 by the Journal of Clinical Investigation.

Pancreatic ductal adenocarcinoma is a difficult disease to treat and some believe that its therapeutic resistance could be attributed to ineffective chemotherapy delivery to cancer cells. Lead author Eugene J. Koay, MD, PhD, and colleagues enrolled 12 patients with primary pancreatic disease who were slated to undergo a surgical resection in their study. Each patient was infused with gemcitabine, a chemotherapy drug, during surgery. After surgery, the researchers analyzed tumor DNA to assess the drug’s penetration.

Analysis revealed that gemcitabine penetrated the tumors at various levels in the 12 patients. Those who had greater levels of the drug responded better to therapy and exhibited improved outcomes. Koay and colleagues then examined scans from 176 patients, 110 of whom received chemotherapy treatment with the drug prior to surgery and 55 who had surgery immediately to remove the tumor.

The resected tumors demonstrated up to six-fold differences in gemcitabine incorporation.  

“With further validation and optimization, our CT analysis method may find wide clinical application for both diagnostic and therapeutic-planning purposes, as the principles of mass transport can be applied to any human pathological process as well as a variety of therapeutic agents,” wrote Koay and colleagues.

Future research is necessary to standardize the system of matching patients’ tumors with the most promising drugs, concluded the authors.