Ph. D. Project
Title:
Interest in the analysis of circulating nucleic acids in patients with borderline resectable pancreatic carcinoma treated with
neoadjuvant mFolfirinox with or without preoperative concomitant chemoradiotherapy, ancillary study to the PANDAS-
PRODIGE 44 trial, TransPANDAS study
Dates:
2024/10/01 - 2027/09/30
Supervisor(s):
Other supervisor(s):
Dr Aurélien Lambert
Description:
Surgery, especially if followed by adjuvant chemotherapy, offers the only chance of cure for pancreatic cancer. At first
diagnosis, after careful evaluation, only 10 to 15% of patients are considered candidates for surgical resection and
approximately 7% have potentially resectable disease. These potentially resectable tumors termed "borderline resectable
pancreatic cancer" (BRPC) are conceptualized as those that involve the mesenteric vasculature to a limited extent and those for
which resection, although possible, would likely be compromised by positive surgical margins (R1 ) in the absence of
neoadjuvant treatment. R0 resection is in fact considered an independent prognostic factor for survival when surgical
procedures, histological examination and definition of microscopic invasion are standardized.
The goals of neoadjuvant treatments for BRPC are to reduce the tumor volume before surgery in order to improve the chances
of radical resection (R0) and to reduce the rate of lymph node positivity and recurrence. The primary endpoint of published
studies is generally the R0 resection rate, but these results also depend on the number of margins examined and the definition of
microscopic margin involvement. Prospective studies with consistent selection criteria and standardized endpoints are needed.
Different neoadjuvant therapeutic strategies have been tested in pilot studies: preoperative chemoradiotherapy or neoadjuvant
chemotherapy, followed or not by preoperative (chemo)radiotherapy. Due to the lack of randomized studies, the best sequence
of treatment administration has not been established.
The aim of this prospective, randomized, multicenter trial is to evaluate the rate of R0 resection with neoadjuvant Folfirinox,
followed or not by chemoradiotherapy for patients with borderline resectable pancreatic cancers. Patient inclusions and follow-
up are now complete and the final results will be presented in September 2024.
The proposed thesis work is a translational study to the PANDAS study: TranPANDAS. The aim of the TransPANDAS study is
to determine whether the use of liquid biopsy allows better management of patients with pancreatic adenocarcinoma treated
with neoadjuvant chemotherapy with mFOLFIRINOX associated or not with chemoradiotherapy. To do this, we propose to
analyze circulating tumor DNA and circulating miRs from plasma collected from the 130 patients included in the PANDAS
study. Each patient underwent repeated blood sampling.
diagnosis, after careful evaluation, only 10 to 15% of patients are considered candidates for surgical resection and
approximately 7% have potentially resectable disease. These potentially resectable tumors termed "borderline resectable
pancreatic cancer" (BRPC) are conceptualized as those that involve the mesenteric vasculature to a limited extent and those for
which resection, although possible, would likely be compromised by positive surgical margins (R1 ) in the absence of
neoadjuvant treatment. R0 resection is in fact considered an independent prognostic factor for survival when surgical
procedures, histological examination and definition of microscopic invasion are standardized.
The goals of neoadjuvant treatments for BRPC are to reduce the tumor volume before surgery in order to improve the chances
of radical resection (R0) and to reduce the rate of lymph node positivity and recurrence. The primary endpoint of published
studies is generally the R0 resection rate, but these results also depend on the number of margins examined and the definition of
microscopic margin involvement. Prospective studies with consistent selection criteria and standardized endpoints are needed.
Different neoadjuvant therapeutic strategies have been tested in pilot studies: preoperative chemoradiotherapy or neoadjuvant
chemotherapy, followed or not by preoperative (chemo)radiotherapy. Due to the lack of randomized studies, the best sequence
of treatment administration has not been established.
The aim of this prospective, randomized, multicenter trial is to evaluate the rate of R0 resection with neoadjuvant Folfirinox,
followed or not by chemoradiotherapy for patients with borderline resectable pancreatic cancers. Patient inclusions and follow-
up are now complete and the final results will be presented in September 2024.
The proposed thesis work is a translational study to the PANDAS study: TranPANDAS. The aim of the TransPANDAS study is
to determine whether the use of liquid biopsy allows better management of patients with pancreatic adenocarcinoma treated
with neoadjuvant chemotherapy with mFOLFIRINOX associated or not with chemoradiotherapy. To do this, we propose to
analyze circulating tumor DNA and circulating miRs from plasma collected from the 130 patients included in the PANDAS
study. Each patient underwent repeated blood sampling.
Keywords:
pancreatic cancer, liquid biopsy, cell-freeDNA, miR
Department(s):
| Biology, Signals and Systems in Cancer and Neuroscience |
Funds:
Institut de Cancérologie de Lorraine