Gillson Josef E, Byeon Sooin, Chou Angela, Maloney Sarah, Pavlakis Nick, Clarke Stephen J, Chan David L, Diakos Connie I, Gill Anthony J, Samra Jaswinder S, Mittal Anubhav, Sahni Sumit
Northern Clinical School, Faculty of Medicine and Health, University of Sydney, St Leonards, New South Wales, Australia.
Kolling Institute of Medical Research, University of Sydney, St Leonards, New South Wales, Australia.
Eur J Clin Invest. 2025 Feb;55(2):e14341. doi: 10.1111/eci.14341. Epub 2024 Nov 2.
Neoadjuvant chemotherapy (NAC) can provide improved survival outcomes in pancreatic ductal adenocarcinoma (PDAC) patients who respond to treatment, but currently available biomarkers cannot reliably predict NAC response. This study aimed to determine the potential of a previously identified diagnostic and prognostic biomarker panel (i.e. Ca-125, S100A2, S100A4, Mesothelin and Ca19-9) for the monitoring of NAC-response in PDAC patients.
This single-centre, retrospective study, utilised serum from NAC treated PDAC patients to determine the levels of biomarkers by Enzyme-Linked Immunosorbent Assay (ELISA). The percentage of the tumour bed occupied by viable carcinoma (PVC) was used to divide patients into good (PVC < 50%) and poor (PVC ≥ 50%) NAC-responders. Statistical analysis was performed to measure the ability of individual biomarkers and a biomarker panel in NAC treatment response and patient survival.
Serum specimens from a total of 108 PDAC patients were assessed. Ca-125, Ca19-9 and S100A2 showed a significant positive correlation with PVC. Ca-125 demonstrated a superior ability to monitor NAC treatment response (Area under receiver operating curve (AUC): .6954) compared to the more widely used clinical biomarker, Ca19-9 (AUC: .6291). A panel of Ca-125 and Ca19-9 showed good ability to monitor NAC response in PDAC patients (AUC: .7349). Patients with high levels of both Ca-125 and Ca19-9 were shown to have the poorest overall survival (median overall survival: 17 vs. 30 months).
A serum biomarker panel of Ca-125 and Ca19-9 could be used for effective clinical management of PDAC patients undergoing NAC treatment.
新辅助化疗（NAC）可改善对治疗有反应的胰腺导管腺癌（PDAC）患者的生存结局，但目前可用的生物标志物无法可靠预测NAC反应。本研究旨在确定先前鉴定的诊断和预后生物标志物组合（即Ca-125、S100A2、S100A4、间皮素和Ca19-9）监测PDAC患者NAC反应的潜力。
这项单中心回顾性研究利用接受NAC治疗的PDAC患者的血清，通过酶联免疫吸附测定（ELISA）确定生物标志物水平。用存活癌占据的肿瘤床百分比（PVC）将患者分为NAC反应良好（PVC＜50%）和反应不佳（PVC≥50%）两组。进行统计分析以衡量单个生物标志物和生物标志物组合对NAC治疗反应和患者生存的预测能力。
共评估了108例PDAC患者的血清样本。Ca-125、Ca19-9和S100A2与PVC呈显著正相关。与更广泛使用的临床生物标志物Ca19-9（曲线下面积[AUC]：0.6291）相比，Ca-125监测NAC治疗反应的能力更强（AUC：0.6954）。Ca-125和Ca19-9组合在监测PDAC患者NAC反应方面表现出良好能力（AUC：0.7349）。Ca-125和Ca19-9水平均高的患者总生存期最差（中位总生存期：17个月对30个月）。
Ca-125和Ca19-9的血清生物标志物组合可用于接受NAC治疗的PDAC患者的有效临床管理。
