Development of precision mdedicine for pancreatic ductal adenocarcinoma by endoscopic ultrasound-guided fine-needle aspiration specimen

2022 Fiscal Year Final Research Report

• Project/Area Number: 17K09479
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Gastroenterology
• Research Institution: Nagoya City University
• Principal Investigator: Naitoh Itaru 名古屋市立大学, 医薬学総合研究院(医学), 講師 (30527750)
• Co-Investigator(Kenkyū-buntansha): 吉田 道弘 名古屋市立大学, 医薬学総合研究院(医学), 講師 (20636328) ; 加藤 晃久 名古屋市立大学, 医薬学総合研究院(医学), 助教 (10803489)
• Project Period (FY): 2017-04-01 – 2023-03-31
• Keywords: 膵癌 / 化学療法 / 超音波内視鏡下生検 / GnP療法 / FOLFORINOX療法

Outline of Final Research Achievements

We retrospectively reviewed patients with PDAC who received GnP or FFX as first-line chemotherapy and examined immunohistochemically the TUBB3 expression in specimens obtained by endoscopic ultrasound-guided fine-needle aspiration.　We evaluateded the association between TUBB3 and various outcomes (response rate (RR), disease control rate (DCR), progression-free survival (PFS) and overall survival （OS)) in GnP group and FFX group. High TUBB3 expression was associated with a significantly lower DCR and shorter PFS, and multivariate analysis revealed that TUBB3 expression was an independent variable for PFS in the GnP group. On the contrary, TUBB3 expression was not correlated with PFS or OS in FFX group. TUBB3 might be a predictive factor for the response ofGnP, but not a prognostic factor for OS, helping the selection of an optimized first-line chemotherapy regimen for unresectable PDAC.

Free Research Field

消化器内科

Academic Significance and Societal Importance of the Research Achievements

切除不能膵癌に対する一次化学療法としてはGnP療法とFFX療法が第一選択になっているが、両者の選択基準は明らかとなっておらず、化学療法の効果予測因子の確立が急務である。今回、超音波内視鏡下生検（EUS-FNA）検体を用いたTUBB3の腫瘍内発現が、GnP療法における効果予測因子になり得る可能性が示唆された。この結果は、切除不能膵癌に対する化学療法を選択する際の重要な基準になると考えられる。