Abstract
Introduction: Recently, novel chemoterapeutic agents like Nab-paclitaxel and gemcitabine demonstrated a survival benefit over gemcitabine alone in metastatic pancreatic cancer. However, there are limited results using this chemotherapy in potentially resectable pancreatic adenocarcinoma. Our aim is to report the oncological results of patients affected by potentially resectable pancreatic adenocarcinoma that underwent surgey after a combination of gemcitabine and nab-paclitaxel. Methods: A total of 25 patients with pancreatic adenocarcinoma received preoperative gemcitabine plus nab-paclitaxel based chemotherapy. We evaluated the following data:(1)Toxicity related to neoadjuvancy;(2)Tumoral response rate (tumoral size at CT scan, SUV of FDG PET-CT scan and CA 19.9;(3)Pattern of the treatment failure during neoadjuvancy, including local recurrence, peritoneal dissemination, and distant metastasis;(4)Resection rate;(5)Rate of R0 resection and hystopathological response to neoadjuvant treatment and(6)Survival and disease free survival. Results: Overall treatment was well tolerated. Treatment resulted in significant antitumoral activity by a statistical decrease of tumoral size (p = 0.04), CA19.9 (p = 0.03) and SUV (p = 0.03). The resection rate was 68% (17/25 patients). All specimens were margin free from disease and 13 of 17 specimens had major pathological regressions. Median survival and median disease free survival of patients that underwent surgery was 30.2 months and 18 months, respectively with a mean follow up of 40 months. Conclusions: This data suggests that nab-paclitaxel and gemcitabine is a safe and effective neoadjuvant treatment for potencially resectable pancreatic adenocarcinoma. This data should be confirmed in larger, randomized studies.
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