Stromal disrupting effects of nab-paclitaxel in pancreatic cancer

被引：241

作者：

Alvarez, R. ^{[1
]}

Musteanu, M. ^{[2
]}

Garcia-Garcia, E. ^{[2
]}

Lopez-Casas, P. P. ^{[2
]}

Megias, D. ^{[2
]}

Guerra, C. ^{[2
]}

Munoz, M. ^{[2
]}

Quijano, Y. ^{[1
]}

Cubillo, A. ^{[1
]}

Rodriguez-Pascual, J. ^{[1
]}

Plaza, C. ^{[1
]}

de Vicente, E. ^{[1
]}

Prados, S. ^{[1
]}

Tabernero, S. ^{[1
]}

Barbacid, M. ^{[2
]}

Lopez-Rios, F. ^{[1
]}

Hidalgo, M. ^{[1
,2
]}

机构：

[1] CIOCC, Madrid 28050, Spain

[2] Spanish Natl Canc Res Ctr CNIO, Madrid 28029, Spain

来源：

BRITISH JOURNAL OF CANCER | 2013年 / 109卷 / 04期

基金：

欧洲研究理事会;

关键词：

PDA; stroma; nab-paclitaxel; CAF; DUCTAL ADENOCARCINOMA; PATHOLOGICAL RESPONSE; EUS ELASTOGRAPHY; MOUSE MODEL; GEMCITABINE; MASSES;

D O I：

10.1038/bjc.2013.415

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Nab-paclitaxel and gemcitabine have demonstrated a survival benefit over gemcitabine alone in advanced pancreatic cancer (PDA). This study aimed to investigate the clinical, biological, and imaging effects of the regimen in patients with operable PDA. Methods: Patients with operable PDA received two cycles of nab-paclitaxel and gemcitabine before surgical resection. FDG-PET and CA19.9 tumour marker levels were used to measure clinical activity. Effects on tumour stroma were determined by endoscopic ultrasound (EUS) elastography. The collagen content and architecture as well as density of cancer-associated fibroblasts (CAFs) were determined in the resected surgical specimen and compared with a group of untreated and treated with conventional chemoradiation therapy controls. A co-clinical study in a mouse model of PDA was conducted to differentiate between the effects of nab-paclitaxel and gemcitabine. Results: A total of 16 patients were enrolled. Treatment resulted in significant antitumour effects with 50% of patients achieving a >75% decrease in circulating CA19.9 tumour marker and a response by FDG-PET. There was also a significant decrement in tumour stiffness as measured by EUS elastography. Seven of 12 patients who completed treatment and were operated had major pathological regressions. Analysis of residual tumours showed a marked disorganised collagen with a very low density of CAF, which was not observed in the untreated or conventionally treated control groups. The preclinical co-clinical study showed that these effects were specific of nab-paclitaxel and not gemcitabine. Conclusion: These data suggest that nab-paclitaxel and gemcitabine decreases CAF content inducing a marked alteration in cancer stroma that results in tumour softening. This regimen should be studied in patients with operable PDA.

引用

页码：926 / 933

页数：8

共 19 条

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