Neoadjuvant Therapy Impact on Pancreatic Cancer: Fibrotic Response Variation and Survival Associations

Examining pancreatic ductal adenocarcinoma (PDAC) cases (1991-2020) with neoadjuvant treatment (NAT), this study categorizes fibrotic responses and explores their links to different NAT strategies (chemotherapy, chemoradiation, or total neoadjuvant therapy, TNT). Major fibrosis, most prevalent in TNT cases, correlates with superior outcomes, including higher rates of downstaging, complete responses, favorable margins, and improved overall and disease-free survival. The study underscores the significance of fibrotic response assessment in understanding treatment efficacy and predicting PDAC patient outcomes.