TWIST1 is a prognostic factor for neoadjuvant chemotherapy for patients with resectable pancreatic cancer: a preliminary study

• Published in: Surgery today (Tokyo, Japan) Vol. 53; no. 5; pp. 633 - 639
• Main Authors: Fujiwara, Sho, Saiki, Yuriko, Fukushige, Shinichi, Yamanaka, Mie, Ishida, Masaharu, Motoi, Fuyuhiko, Unno, Michiaki, Horii, Akira
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01.05.2023
• Subjects: Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Carcinoma, Pancreatic Ductal - drug therapy; Carcinoma, Pancreatic Ductal - pathology; Carcinoma, Pancreatic Ductal - surgery; Chemotherapy, Adjuvant; Humans; Medicine; Medicine & Public Health; Neoadjuvant Therapy; Neoplasm Recurrence, Local; Nuclear Proteins - genetics; Nuclear Proteins - therapeutic use; Pancreatic Neoplasms; Pancreatic Neoplasms - drug therapy; Pancreatic Neoplasms - surgery; Prognosis; Short Communication; Surgery; Surgical Oncology; Twist-Related Protein 1 - genetics; Neoadjuvant chemotherapy; TWIST1; Epithelial-to-mesenchymal transition
• ISSN: 0941-1291; 1436-2813; 1436-2813
• DOI: 10.1007/s00595-023-02655-3

Recent advances in the development of chemotherapies have helped improve the prognosis of pancreatic ductal adenocarcinoma (PDAC). However, predicting factors for the outcomes of chemotherapies (either gemcitabine or S-1) have not yet been established. We analyzed the expression of 4 major epithelial-to-mesenchymal transition-inducing transcription factors in 38 PDAC patients who received adjuvant chemotherapy after radical resection to examine the association with patients’ prognoses. The TWIST1-positive group showed a significantly poorer prognosis than the TWIST1-negative group for both the relapse‐free survival (median survival time [MST] of 8.9 vs. 18.5 months, P  = 0.016) and the overall survival (MST of 15.2 vs. 33.4 months, P  = 0.023). A multivariate analysis revealed that TWIST1 positivity was an independent prognostic factor for a poor response to adjuvant chemotherapies (hazard ratio 2.61; 95% confidence interval 1.10–6.79; P  = 0.029). These results suggest that TWIST1 can be utilized as an important poor prognostic factor for radically resected PDAC patients with adjuvant chemotherapy, potentially including neoadjuvant therapy using these agents.