Department of Surgery, McGaw Medical Center of Northwestern University, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Department of Surgery, McGaw Medical Center of Northwestern University, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, USA.
Chin Clin Oncol. 2022 Aug;11(4):30. doi: 10.21037/cco-22-49.
Pancreatic cancer is the 4th leading cause of cancer death in the US, with incidence increasing over the last 20 years. Recently neoadjuvant therapy (NAT) has emerged as an important tool in improving resectability and overall survival. The objective is to describe and discuss the current literature on the use of biomarkers in measuring response to NAT in pancreatic adenocarcinoma.
An electronic review of PubMed, Google Scholar and Cochrane was performed to obtain key literature on serum, imaging, clinical, and histologic biomarkers utilized to measure response to NAT in pancreatic cancer. This literature review included publications in English written between January 1, 2011 to March 31, 2022.
An overview of four categories of biomarkers was evaluated for their utility in assessing both pathologic response and overall survival following NAT in pancreatic adenocarcinoma. Serum CA19-9 as well as CT radiomic features, FDG PET response and development of histologic grading system all show promise as markers of response to NAT.
While multiple promising modalities exist, all require some form of standardization in terms of predicting response to NAT. Further investigation and large-scale studies to evaluate the efficacy of various imaging modalities are necessary. Additionally, there needs to be standardization of histologic grading system post NAT, and consensus on CA19-9 cutoff values in determining NAT response.
在美国，胰腺癌是第 4 大癌症死因，其发病率在过去 20 年中呈上升趋势。最近，新辅助治疗（NAT）已成为提高可切除性和总体生存率的重要手段。本研究旨在描述和讨论目前关于生物标志物在测量胰腺腺癌对 NAT 反应中的应用的文献。
通过电子检索 PubMed、Google Scholar 和 Cochrane，获取关于用于测量胰腺癌 NAT 反应的血清、影像学、临床和组织学生物标志物的关键文献。本文献综述包括 2011 年 1 月 1 日至 2022 年 3 月 31 日期间发表的英文文献。
评估了四类生物标志物，以评估它们在胰腺腺癌 NAT 后病理反应和总体生存率方面的效用。血清 CA19-9 以及 CT 放射组学特征、FDG PET 反应和组织学分级系统的发展均显示出作为 NAT 反应标志物的潜力。
虽然存在多种有前途的方法，但所有方法都需要在预测 NAT 反应方面进行某种形式的标准化。需要进一步研究和大规模研究来评估各种影像学方法的疗效。此外，NAT 后需要对组织学分级系统进行标准化，并就 CA19-9 截止值在确定 NAT 反应方面达成共识。
