Development of personalized multimodal therapy for pancreatic cancer through comprehensive ctDNA mutation analysis monitoring

2023 Fiscal Year Final Research Report

• Project/Area Number: 21K08803
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 55020:Digestive surgery-related
• Research Institution: Hyogo Medical University
• Principal Investigator: Hirono Seiko 兵庫医科大学, 医学部, 教授 (60468288)
• Co-Investigator(Kenkyū-buntansha): 北畑 裕司 和歌山県立医科大学, 医学部, 講師 (00535338) ; 山上 裕機 和歌山県立医科大学, 医学部, 学長特命教員(特別顧問) (20191190) ; 川井 学 和歌山県立医科大学, 医学部, 教授 (40398459) ; 岡田 健一 和歌山県立医科大学, 医学部, 講師 (50407988) ; 宮澤 基樹 和歌山県立医科大学, 医学部, 博士研究員 (90549734)
• Project Period (FY): 2021-04-01 – 2024-03-31
• Keywords: 膵癌 / ctDNA変異解析 / 化学療法

Outline of Final Research Achievements

Blood samples were collected before and after preoperative chemotherapy and after surgery from 28 cases of pancreatic cancer who underwent surgical resection following GEM/nab-PTX combination therapy. Monitoring of ctDNA mutation analysis revealed no difference in survival between cases with and without detectable ctDNA before and after preoperative treatment. However, cases with detectable ctDNA after surgery had significantly poorer survival, indicating that the evaluation of postoperative ctDNA mutations was most useful as a prognostic factor for pancreatic cancer. Monitoring ctDNA mutation analysis every three months after surgery detected ctDNA mutations earlier than imaging in 8 out of 13 recurrent cases, demonstrating that ctDNA mutation analysis is useful for the early diagnosis of postoperative recurrence.

Free Research Field

膵癌

Academic Significance and Societal Importance of the Research Achievements

本研究により、膵癌患者の長期生存には、術前化学療法後に外科的切除を施行し、さらに術後補助療法を行う集学的治療が必須で、上記で示したように膵癌治療中にctDNA変異解析をモニタリングすることで治療効果の評価が可能であることがわかった。今後さらなる症例数の蓄積と生存期間の観察期間の延長による解析が必要であるが、本研究の成果は、膵癌患者の長期生存に大いに貢献できると考える。