Clinical Significance of Dihydropyrimidine Dehydrogenase in Adjuvant 5-Fluorouracil Liver Perfusion Chemotherapy for Pancreatic Cancer

Abstract

An immunohistochemical evaluation of intratumoral DPD expression might be useful in predicting responsiveness to 5-FU-based chemotherapy in pancreatic cancer patients. In the DPD(-) group, liver perfusion chemotherapy using 5-FU via the portal vein is effective adjuvant therapy for pancreatic cancer once pancreatectomy has been performed.

Beneficial Effects of 5-Fluorouracil and Heparin-Based Portal Infusion Chemotherapy Combined with Mitomycin C and Cisplatin after Curative Resection of Pancreatic Cancer

“…However, the postoperative survival period in patients treated with 5-FU through the portal vein for 2 weeks was still limited, and thus, these results were unsatisfactory. In a strategy similar to ours, Nakayama et al [13] continuously infused 250 mg/day of 5-FU via the portal vein for 3 weeks immediately after radical surgery in pancreatic cancer patients. As a result, patients who received 5-FU liver perfusion chemotherapy, especially those with negative expression of dihydropyrimidine dehydrogenase in the tumors, showed a significantly higher survival rate than those without the therapy.…”

Pharmacogenetics of anticancer drug sensitivity in pancreatic cancer

“…An immunohistochemical evaluation of DPD expression in 68 pancreatic tumors revealed that in the DPD low-expression group the adjuvant 5-FU chemotherapy subgroup showed a significantly higher survival rate than the untreated subgroup. Moreover, among the treated patients, OS was significantly better in the DPD-negative subgroup than in the DPD-positive subgroup (49). Similarly, a recent study showed that high TS immunoreactivity, detected in 43% and 47% of the primary and metastatic lesions, respectively, had a significant influence on the outcome of patients with resectable pancreatic cancer, and the rate of survival of the high TS group was significantly higher than that of the negative or low reactivity groups.…”

Prognostic Implications of Intraoperative Radiotherapy for Unresectable Pancreatic Cancer

“…In addition, more efforts could be focused on controlling liver metastasis to avoid hepatic failure. In this regard, IORT combined with liver perfusion chemotherapy could be one of the most reasonable treatment options in cases of liver metastasis [28,33]. …”