Impact of center-level protocol adherence on neoadjuvant treatment outcome in pancreatic ductal adenocarcinoma.
Eur J CancerSep 10, 2026 (epub)
Clinical ResearchOncology (Medical)
Anna Fosfuri, Giulia Orsi, Catia Carconi et al.
✦ AI-curated · Sources linked
In 30 seconds
This multicenter phase III trial analyzed the impact of chemotherapy dose reductions and protocol adherence on event-free survival (EFS) in 260 patients with resectable and borderline resectable pancreatic ductal adenocarcinoma (PDAC). The study found that patients treated at centers with higher protocol violation rates had significantly shorter EFS (10.3 vs 14.5 months; p = 0.040).
Key findings
- Protocol violations were more frequent in the PAXG arm compared to mFOLFIRINOX (27% vs 16%; p = 0.047).
- Reduced platinum salts relative dose intensity (RDI) was associated with shorter EFS (9.3 vs 15.1 months; p = 0.014).
- Higher center-level protocol violation rates correlated with significantly shorter EFS (10.3 vs 14.5 months; p = 0.040).
Why it matters
Understanding the impact of protocol adherence on treatment outcomes can help clinicians optimize neoadjuvant strategies for PDAC, potentially improving patient survival rates. This study highlights the importance of maintaining treatment protocols to enhance efficacy.