For patients with advanced pancreatic cancer, pancreatic enzyme replacement therapy (PERT) may potentially improve nutritional status during chemotherapy, according to a study published in the journal Pancreas.

Given that there is limited literature on the use of PERT in pancreatic cancer (PC), researchers from University of Tokyo aimed to investigate the potential benefits of this therapy in PC patients, especially those receiving chemotherapy. For this study, researchers prospectively enrolled patients with unresectable pancreatic cancer receiving chemotherapy between April 2012 and February 2014; 91 patients were included in the analysis with 46 patients in the pancrelipase group and 45 in the historical cohort (patients receiving chemotherapy before April 2012). Data on nutritional markers (body mass index [BMI], albumin, total cholesterol) were collected at baseline and then assessed at 16 weeks; change from baseline was compared between the two groups. N-benzoyl-tryrosyl para-aminobenzoic acid (NBT-PABA) test was used to assess pancreatic exocrine function. 

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In the pancrelipase group, the NBT-PABA test was found to be low in 94% of patients. Change from baseline for BMI was 1.01 for the pancrelipase group compared to 0.95 in the historical cohort (P<0.001). This significant change in BMI, the authors noted, suggests that PERT may help prevent weight loss due to malabsorption in these patients. With regards to serum albumin, the change from baseline was 1.03 for the pancrelipase group versus 0.97 for the historical cohort (P=0.131). 

While the study had several limitations, based on the findings, the authors concluded that pancrelipase tended to improve nutritional status in these patients. “Although the impact of PERT on the prognosis was unclear because of the small sample size and the imbalance between 2 cohorts, we believe the role of PERT should be further investigated.”

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