Prior to surgery, the use of positron emission tomography (PET) with 18-fluorodeoxyglucose (FDG) tracer provides a considerable predictive advantage when assessing neoadjuvant treatment response in patients with borderline resectable/locally advanced pancreatic cancer.
According to past research, conventional imaging modalities such as CT and/or MRI are inefficient at predicting the outcomes of pancreatic cancer patients undergoing neoadjuvant chemotherapy prior to surgery. Similar inconsistency and impossibility exist when attempting to measure biochemical CA 19-9 level increases in a significant proportion of patients. Before doing significant surgery, this left specialists with little choices for determining the likelihood of long-term survival.
202 individuals with locally advanced/borderline resectable pancreatic cancer got either mFOLFIRINOX or gemcitabine/nab-paclitaxel as first-line neoadjuvant treatment. Regardless of biochemical response as evaluated by CA 19-9 levels, a substantial metabolic reaction detected by FDG-PET was strongly related to a major pathologic response, i.e. tumor decrease. The combination of both characteristics was significantly more predictive.
JOURNAL REFERENCE
FDG-PET Predicts Neoadjuvant Therapy Response and Survival in Borderline Resectable/Locally Advanced Pancreatic Adenocarcinoma, Journal of the National Comprehensive Cancer Network (2022). DOI: 10.6004/jnccn.2022.7041