Evidence map›Paper›PMID 42319588›Full record

ArticleAnnals of surgical oncology2026

Assessing Response and Outcomes to Modern Multiagent Neoadjuvant Therapy for Pancreatic Ductal Adenocarcinoma.

Paul H McClelland, Megan A Satyadi, Ryan P Johnson, Rosetta Jacob, Jianmin Pan, Jayesh Rai, Shesh Rai, Davendra Sohal, Olugbenga Olowokure, Jordan Kharofa and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
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

13 authors.

Paul H McClellandDepartment of Surgery, University of Cincinnati Medical Center, Cincinnati, OH, USA.
Megan A SatyadiDepartment of Surgery, University of Cincinnati Medical Center, Cincinnati, OH, USA.
Ryan P JohnsonDepartment of Surgery, University of Cincinnati Medical Center, Cincinnati, OH, USA.
Rosetta JacobDepartment of Surgery, University of Cincinnati Medical Center, Cincinnati, OH, USA.
Jianmin PanBiostatistics and Informatics Shared Resource, University of Cincinnati Cancer Center, University of Cincinnati, Cincinnati, OH, USA.
Jayesh RaiBiostatistics and Informatics Shared Resource, University of Cincinnati Cancer Center, University of Cincinnati, Cincinnati, OH, USA.
Shesh RaiBiostatistics and Informatics Shared Resource, University of Cincinnati Cancer Center, University of Cincinnati, Cincinnati, OH, USA.
Davendra SohalDepartment of Internal Medicine, Division of Hematology and Oncology, University of Cincinnati Medical Center, Cincinnati, OH, USA.
Olugbenga OlowokureDepartment of Internal Medicine, Division of Hematology and Oncology, University of Cincinnati Medical Center, Cincinnati, OH, USA.
Jordan KharofaDepartment of Radiation Oncology, University of Cincinnati Medical Center, Cincinnati, OH, USA.
Gregory C WilsonDepartment of Surgery, University of Cincinnati Medical Center, Cincinnati, OH, USA.
Sameer H PatelDepartment of Surgery, University of Cincinnati Medical Center, Cincinnati, OH, USA.
Syed A AhmadDepartment of Surgery, University of Cincinnati Medical Center, Cincinnati, OH, USA. ahmadsy@ucmail.uc.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNeoadjuvant therapy (NAT) is increasingly used for resectable and borderline-resectable pancreatic ductal adenocarcinoma (PDAC), yet interpretation of treatment response remains challenging. PATIENTS AND

methodsA single-center retrospective review was conducted of patients with resectable or borderline-resectable PDAC treated with multiagent NAT between 2008 and 2024. Radiographic response was assessed using RECIST 1.1 criteria, biochemical response by serum CA 19-9 reduction, and histopathologic response by College of American Pathologists (CAP) score. Primary and secondary outcomes were overall survival (OS) and progression-free survival (PFS).

resultsAmong 166 patients, 148 (89%) completed NAT and 121 (73%) underwent resection. After NAT, radiographic response was uncommon: 27% had tumor regression, 66% stable disease, and 7% progressive disease. By contrast, 83% achieved ≥ 45% CA 19-9 reduction after NAT, and 74% demonstrated histopathologic response after resection, including 8% complete pathologic response. Among resected patients with radiographically stable/progressive disease, 88% had biochemical response and 68% at least partial histopathologic response. Neither radiographic nor biochemical response were significantly associated with improved PFS or OS. Histopathologic response (CAP 0-2) was associated with improved PFS/OS on univariable analysis as well as improved PFS on multivariable analysis [adjusted hazard ratio (aHR) 0.57, 95% confidence interval (CI) 0.34-0.96; p = 0.034]. Isolated unresectable local progression during NAT was rare (n = 2).

conclusionsWhile imaging response and downstaging can occur with NAT, histopathologic response is more predictive of long-term survival and often occurs despite stable or progressive disease on imaging. Isolated unresectable local progression after NAT is rare, though broader treatment-related attrition remains a consideration in neoadjuvant sequencing.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsCarcinoma, Pancreatic DuctalNeoadjuvant TherapyPancreatic NeoplasmsAgedAged, 80 and overFemaleFollow-Up StudiesHumansMaleMiddle AgedPancreatectomyPrognosisRetrospective StudiesSurvival Rate

Identifiers

PMID42319588
PMCPMC13452754

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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.