CT Scans Can ID Gemcitabine Response in Pancreatic Cancer
(HealthDay News) — Transport properties identified on routine computed tomography (CT) scans correlate with clinically relevant end points for patients with pancreatic ductal adenocarcinoma (PDAC) who receive preoperative gemcitabine chemoradiotherapy, according to a study published online March 10 in the Journal of Clinical Investigation.
Eugene J. Koay, MD, PhD, from the University of Texas MD Anderson Cancer Center in Houston, and colleagues measured mass transport properties in individual human PDAC tumors using contrast-enhanced CT scans. In addition, they assessed gemcitabine infusion during PDAC resection in 12 patients and measured gemcitabine incorporation into tumor DNA. Associations between CT-derived mass transport properties and clinical outcomes were assessed in patients who received preoperative gemcitabine-based chemoradiotherapy for resectable PDAC.
The researchers found that transport properties differed considerably between normal pancreas and tumor, with a wide array of enhancement profiles seen on CT scans. Despite similar intravascular pharmacokinetics, resected tumors exhibited considerable differences in gemcitabine DNA incorporation, reflecting interpatient differences in contrast enhancement. After accounting for human equilibrative nucleoside transporter levels, there was an inverse association between gemcitabine incorporation into tumor DNA and CT-derived transport parameters and PDAC stromal score. There was a direct correlation between stromal score and CT-derived parameters. CT-derived parameters correlated with pathological response and survival in 110 patients who received preoperative gemcitabine-based chemoradiotherapy.
"Gemcitabine incorporation into tumor DNA is highly variable and correlates with multiscale transport properties that can be derived from routine CT scans," the authors write. "Furthermore, pretherapy CT-derived properties correlate with clinically relevant end points."