title: Fluorescence-guided surgery, but not bright-light surgery, prevents local recurrence in a pancreatic cancer patient derived orthotopic xenograft (PDOX) model resistant to neoadjuvant chemotherapy (NAC).
abstract: BACKGROUND
  The aim of this study is to determine the efficacy of neoadjuvant chemotherapy (NAC) with gemcitabine (GEM) in combination with fluorescence-guided surgery (FGS) on a pancreatic cancer patient derived orthotopic xenograft (PDOX) model.
  
  
  METHODS
  A PDOX model was established from a CEA-positive tumor from a patient who had undergone a pancreaticoduodenectomy for pancreatic adenocarcinoma. Mice were randomized to 4 groups: bright light surgery (BLS) only; BLS + NAC; FGS only; and FGS + NAC. An anti-CEA antibody conjugated to DyLight 650 was administered intravenously via the tail vein of mice with a pancreatic cancer PDOX 24 h before surgery.
  
  
  RESULTS
  The PDOX was clearly labeled with fluorophore-conjugated anti-CEA antibody. Only one out of 8 mice had local recurrence in the FGS only group and zero out of 8 mice had local recurrence in the FGS + NAC which was significantly lower than BLS only or BLS + NAC mice, where local disease recurred in 6 out of 8 mice in each treatment group (p = 0.041 and p = 0.007, respectively). NAC did not significantly reduce recurrence rates when combined with either FGS or BLS.
  
  
  CONCLUSIONS
  These results indicate that FGS can significantly reduce local recurrence compared to BLS in pancreatic cancer resistant to NAC.
authors: AntiCancer, Inc., San Diego, CA, USA; Department of Surgery, University of California San Diego, San Diego, CA, USA; Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors: Yukihiko
authors: Y
authors: Hiroshima
authors: Department of Surgery, University of California San Diego, San Diego, CA, USA.
authors: Ali
authors: A
authors: Maawy
authors: AntiCancer, Inc., San Diego, CA, USA.
authors: Yong
authors: Y
authors: Zhang
authors: Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors: Takashi
authors: T
authors: Murakami
authors: Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors: Masashi
authors: M
authors: Momiyama
authors: Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors: Ryutaro
authors: R
authors: Mori
authors: Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors: Ryusei
authors: R
authors: Matsuyama
authors: Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors: Takashi
authors: T
authors: Chishima
authors: Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors: Kuniya
authors: K
authors: Tanaka
authors: Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors: Yasushi
authors: Y
authors: Ichikawa
authors: Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors: Itaru
authors: I
authors: Endo
authors: AntiCancer, Inc., San Diego, CA, USA; Department of Surgery, University of California San Diego, San Diego, CA, USA.
authors: Robert M
authors: RM
authors: Hoffman
authors: Department of Surgery, University of California San Diego, San Diego, CA, USA. Electronic address: mbouvet@ucsd.edu.
authors: Michael
authors: M
authors: Bouvet
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000601:surgery*; D000818:Animals; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D019008:Drug Resistance, Neoplasm; D005456:Fluorescent Dyes; D064593:Heterografts; D006801:Humans; D008027:Light; D051379:Mice; D016688:Mice, Inbred NOD; D008819:Mice, Nude; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D009368:Neoplasm Transplantation; D061848:Optical Imaging; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000601:surgery*; D011897:Random Allocation; D014183:Transplantation, Heterologous; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D005456:Fluorescent Dyes; D003841:Deoxycytidine; D000093542:Gemcitabine
keywords: CEA; Fluorescence-guided surgery; Neoadjuvant chemotherapy; PDOX; Pancreatic cancer; Patient derived orthotopic xenograft