Evidence map›Paper›PMID 40494893›Full record

ArticleBritish journal of cancer2025

Intratumoral bacterial abundance confers poor response to adjuvant gemcitabine in resected pancreatic cancer patients which is mitigated by postoperative antibiotics.

Michael Guenther, Sai Agash Surendran, Nina Hauer, Florian Fahrenschon, Muhammed Dervis Arslan, Steffen Ormanns

Abstract read
In one paragraph

Article in British journal of cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Michael Guenther *Innpath Institute of Pathology, Tirol Kliniken, Innsbruck, Austria.ORCID http://orcid.org/0009-0001-5091-5060
Sai Agash Surendran *Institute of Pathology, Faculty of Medicine, Ludwig-Maximilians-University, Munich, Germany.
Nina HauerInstitute of Pathology, Faculty of Medicine, Ludwig-Maximilians-University, Munich, Germany.
Florian FahrenschonInstitute of Pathology, Faculty of Medicine, Ludwig-Maximilians-University, Munich, Germany.
Muhammed Dervis ArslanInstitute of Pathology, Faculty of Medicine, Ludwig-Maximilians-University, Munich, Germany.
Steffen OrmannsInnpath Institute of Pathology, Tirol Kliniken, Innsbruck, Austria. steffen.ormanns@i-med.ac.at.ORCID http://orcid.org/0000-0002-0754-9034

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAdjuvant gemcitabine (aGC) is still a therapeutic mainstay after resection of pancreatic ductal adenocarcinoma (PDAC), but its efficacy is impaired by gram-negative intratumoral bacteria, suggesting a potential therapeutic implication of additive antibiotics. PDAC however, contains several other bacterial strains capable of gemcitabine degradation.

methodsUsing immunohistochemistry and fluorescence-in-situ-hybridization on the samples of a large cohort of resected PDAC patients, we examined how the intratumoral bacterial abundance affected patient outcomes with respect to aGC therapy and whether the use of pre- or postoperative antibiotics (ABT) improved the prognosis. We confirmed the findings in several independent external cohorts.

resultsHigh intratumoral bacterial abundance impaired aGC efficacy (disease free survival (DFS) 9.4 vs 19.1 months, p < 0.001; overall survival (OS) 19.4 vs 34.0 months, p < 0.001), which was mitigated by postoperative ABT application (DFS 7.9 vs 12.4 months, p < 0.001, OS 15.2 vs 29.6 months, p < 0.001). Postoperative ABT improved outcome of patients with low bacterial abundance in their tumors (DFS 15.1 vs 34.8 months, p < 0.001, OS 28.5 vs 56.00 months, p < 0.001).

conclusionsHigh intratumoral bacterial abundance may predict poor response to adjuvant gemcitabine treatment, whereas postoperative ABT improves it. We propose postoperative ABT as potential additive treatment before or during aGC therapy after PDAC resection.

Indexed as

Anti-Bacterial AgentsAntimetabolites, AntineoplasticCarcinoma, Pancreatic DuctalDeoxycytidinePancreatic NeoplasmsAgedChemotherapy, AdjuvantDisease-Free SurvivalFemaleGemcitabineHumansMaleMiddle AgedPrognosisAnti-Bacterial AgentsAntimetabolites, AntineoplasticDeoxycytidineGemcitabine

Identifiers

PMID40494893
PMCPMC12356981

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.