Serum MUC5AC as a dynamic biomarker for tumor response, prognosis, and risk stratification in resected pancreatic ductal adenocarcinoma.
Year: 2025
Type: conference-abstract
Study design: Observational Study
Abstract: e16364 Background: There is an unmet need for novel biomarkers to guide and personalize treatment strategies for early-stage pancreatic ductal adenocarcinoma (PDA), specifically in determining whether upfront surgery (UpS) or neoadjuvant therapy (NAT) is the optimal approach. Our prior work demonstrated that extracellular MUC5AC (EC-M) in resected samples and serum MUC5AC (S-M) during NAT predict outcomes with limited utility in the UpS group. We hypothesized that S-M is a dynamic biomarker with significance varying by stage of treatment and surgery. This study evaluates S-M’s correlation with key clinical and pathological features across three stages: at diagnosis (Dx), during NAT, and postoperatively in the UpS group. Methods: Resected tissue and serum samples from PDA patients (2010–2021) were obtained from the Ohio State University biorepository. Enzyme-linked immunoassays (NBP2-76703) quantified S-M levels, and immunohistochemistry using 45M1 monoclonal antibody (ab3649) determined tissue MUC5AC localization and H-scores. Logistic regression was employed to assess correlations between S-M and other parameters. Kaplan-Meier methods estimated progression-free survival (PFS), and median survival times were compared using the log-rank test. Results: The study included 51 patients stratified by serum sample availability: Dx (n = 11), during NAT (n = 23, median 5 weeks of therapy), and Post-UpS (n = 17, median 8 weeks post-surgery). In the Dx group, 2 had UpS, and 9 had NAT. In the NAT group, most patients received FOLFIRINOX as their NAT, whereas gemcitabine-based regimens were more commonly used in the UpS group. Key results are discussed in the table below. Mean S-M was used to compare groups. The primary limitations of this study include the small sample size and the heterogeneity in perioperative therapy regimens among patients. Conclusions: S-M is a dynamic biomarker that correlates with tumor and treatment-related changes, especially during NAT and post-surgery. S-M has strong prognostic value for PFS and OS and may serve as a risk stratification tool for distant metastases post-surgery. Further studies with larger cohorts and serial sampling are warranted to validate these findings. Post-UpS During NAT Dx Serum CA19-9 on the same day Not significant (NS) NS Direct correlation (DC) (p=0.007) Tissue 45M1 expression (H-score) NS DC (0.04) NS EC MUC5AC detection, yes vs. no NS 2.4 vs. 0.9 (0.05) NS Median PFS in months (m),< vs. ≥ median 14.8, 1.5 vs. 0.79 (0.05)(n=8 vs. 9) 7.6, 2.8 vs. 0.8 (0.01)(n=11 vs. 12) NS Median OS in m,< vs. ≥ median 25.8, 0.8 vs. 1.5 (0.02)(n=8 vs. 9) NS NS Distant metastasis vs. local or no recurrence 1.5 vs 0.75 (0.01)(n=9 vs. 8) NS NS Margins status, positive vs. negative NS 2.7 vs. 0.67 (0.002)(n=13 vs. 10) NS Response – near complete vs. partial vs. none Not applicable 0.43 vs. 2.8 vs. 1.2 (0.02)(n= 2 vs. 9 vs. 12) NS in NAT
Source: Journal of Clinical Oncology
Institutions: The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Metropolitan Hospital Center, Wake Forest University, University of Kansas, The University of Kansas Cancer Center, Roswell Park Comprehensive Cancer Center, The Ohio State University
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4410812518