Photo Credit: Dr._Microbe
The following is a summary of “New Biomarkers to Define a Biological Borderline Situation for Pancreatic Adenocarcinoma: Results of an Ancillary Study of the PANACHE01-PRODIGE48 Trial,” published in the November 2024 issue of Surgery by Pinson et al.
Biological borderline situations, first defined by MD Anderson, are used to manage pancreatic adenocarcinoma (PA), with markers like carbohydrate antigen 19.9 (CA19-9) helping to identify patients at higher risk of systemic disease and recurrence.
Researchers conducted a prospective study of the PANACHE01-PRODIGE 48 trial to assess the prognostic value of baseline CA19-9 and circulating tumor DNA (ctDNA) for OS in patients with resectable PA.
They compared characteristics and OS between patients with and without ctDNA status available; OS was estimated using the Kaplan-Meier method and compared with a log-rank test. The restricted cubic spline approach was used to identify the optimal threshold for biological parameters. Univariate and multivariate Cox proportional hazard models were applied to assess associations of ctDNA status and other parameters with OS.
The results showed 132 patients, 92 (71%) had ctDNA, and 14 patients (15%) with ctDNA+ had a higher risk of death (P=0.0188; HR [95% CI]: 2.28 [1.12–4.63]). Among the 92 patients, only CA19-9 was associated with OS in univariate analysis. Patients with CA19-9 ≥ 80 U/mL had a higher risk of death (P=0.0143; HR [95% CI]: 2.2 [1.15–4.19]). In multivariate analysis, CA19-9 remained independently associated with OS (P=0.0323). When combining both biomarkers, the median OS was 19.4 months (95% CI: 3.8-NR) for the “CA19-9 high and ctDNA+” group, 30.2 months (95% CI: 17.1-NR) for the “CA19-9 high or ctDNA+” group, and NR (95% CI: 39.3-NR) for the “CA19-9 low and ctDNA-” group (log-rank P=0.0069).
They concluded combining ctDNA with CA19-9 could help define biological borderline situations in PA.
