Abstract 257P
Background
Pancreatic cancer remains a common cause of cancer deaths worldwide. Neoadjuvant chemotherapy (NAC) can improve the survival outcomes of patients with pancreatic cancer, but for resectable or borderline resectable pancreatic cancer the proportion of conversion to surgery remains unsatisfactory. Under the current treatment modalities, the NAC regiments used for patients may be the regimens with low efficacy, thus leading to a low conversion rate. Here, we used “H” to “H” precision NAC to assess the clinical response of patients with pancreatic cancer based on the patient-derived organoids (PDOs).
Methods
Biopsy samples from resectable or borderline resectable pancreatic cancer patients were collected for generating PDOs. Initially, NAC with gemcitabine plus nab-paclitaxel was administrated, and then the most effective regimen (“H” to “H” precision NAC) was used based on drug screening and patient responses. The primary endpoint was the objective response rate (ORR).
Results
Between June 2023 and March 2024, 19 of 25 patients were eligible for the study after exclusion of 2 unqualified cases and 4 not performed drug sensitivity testing, with the median time of 20 days in organoid culture and 4 days in drug sensitivity testing. Among the 19 patients, 16 achieved partial response and successfully received surgical resection, with the ORR of 84.2%. The R0 resection rate was 81.3% (13/16). During NAC, 8 (42.1%) of 19 patients experienced grade 1-2 adverse events, mainly including myelosuppression, cutaneous pruritus, and diarrhea.
Conclusions
The PDO-based “H” to “H” precision NAC can effectively improve the resectable rate of pancreatic cancer patients, with good tolerance, which may be a novel NAC mode to improve the patients’ prognosis.
Clinical trial identification
Clinical trial registration (2023/5/26): Chinese Clinical Trial Registry (ChiCTR2400082320).
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Chongqing Natural Science Foundation Project (No: CSTB2022NSCQ-MSX0172).
Disclosure
All authors have declared no conflicts of interest.