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Preoperative serum ADAM12 levels as a stromal marker for overall survival and benefit of adjuvant therapy in patients with resected pancreatic and periampullary cancer

  • Dutch Pancreatic Cancer Group
  • University of Amsterdam
  • Erasmus MC
  • Leiden University Medical Center
  • Onze Lieve Vrouwe Gasthuis
  • University Medical Center Utrecht
  • Catharina Hospital
  • Erasmus Universiteit: Department of Gastroenterology and Hepatology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands and the Department of Gastroenterology and Hepatology, Academic Medical Center, University Medical Center, Amsterdam,
  • Leiden University Medical Center, Department of Medical Statistics, Leiden.
  • Department of Sciences, Amsterdam University College, VU Amsterdam/University of Amsterdam, 1012 WX, Amsterdam, The Netherlands
  • Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, the Netherlands; Department of Medical Microbiology, University Medical Center Utrecht, Utrecht University, the Netherlands.

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Background: We evaluated the stroma marker A Disintegrin And Metalloprotease 12 (ADAM12) as a preoperative prognostic and treatment-predictive marker for overall survival (OS) in pancreatic ductal adenocarcinoma (PDAC) and periampullary cancers. Methods: Materials were derived from the prospective nationwide Dutch Pancreas Biobank (2015–2017). We included patients who underwent resection because of PDAC/periampullary cancer or non-invasive IPMN (control group) and had a preoperative serum sample available. ADAM12 levels were dichotomized using a pre-defined cut-off (316 pg/mL). Univariable and multivariable Cox regression analyses (backward selection) were performed. Results: Median ADAM12 levels were 161 (IQR 79–352) pg/mL in 215 PDAC and periampullary adenocarcinomas. High ADAM12 levels (>316 pg/mL) predicted poor OS in the total group of pancreatic and periampullary adenocarcinomas (P = 0.04), but not after adjustment. In distal cholangiocarcinoma (n = 33), high ADAM12 levels predicted poor OS in univariable analysis (P = 0.02), but not in PDAC (P = 0.63). PDAC patients (n = 135) with high ADAM12 levels benefited from adjuvant treatment (median OS 27 vs 14 months, P = 0.02), whereas those with low levels did not (21 vs 21 months, P = 0.87). Conclusion: High circulating ADAM12 levels, as a proxy for activated stroma, predict survival benefit from adjuvant chemotherapy in PDAC, requiring validation in future studies.
Original languageEnglish
Pages (from-to)1886-1896
Number of pages11
JournalHPB
Volume23
Issue number12
Early online date2021
DOIs
Publication statusPublished - Dec 2021

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

  1. SDG 3 - Good Health and Well-being
    SDG 3 Good Health and Well-being

Keywords

  • ADAM12 Protein/blood
  • Adenocarcinoma/drug therapy
  • Carcinoma, Pancreatic Ductal/drug therapy
  • Humans
  • Pancreas
  • Pancreatic Neoplasms/drug therapy
  • Prognosis
  • Prospective Studies
  • Retrospective Studies

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