DYNAMIC-Pancreas: Circulating Tumour DNA Analysis Informing Adjuvant Chemotherapy in Early Stage Pancreatic Cancer - A Multicentre Randomised Study

Pancreatic cancer is an aggressive disease with few long-term survivors. Following resection of early-stage pancreatic adenocarcinoma, adjuvant chemotherapy improves survival outcomes, however earlier relapse rates have been demonstrated when ctDNA is detected before and immediately after curative intent surgery despite standard adjuvant therapy. In comparison, patients with no detectable ctDNA post-surgery had reduced recurrence rates. A reliable prognostic biomarker could therefore improve management decisions (treatment regimen/treatment duration) and enable therapy to be personalised to each patient’s risk of recurrence.
This ctDNA-directed study will focus on tailoring our approach to treatment, answering important questions around who and how we treat, as well as how many drugs need to be administered concurrently in order to achieve better outcomes.

DYNAMIC-Pancreas is a prospective, multi-centre, randomised controlled study enrolling 438 participants with localised adenocarcinoma of the pancreas undergoing either neo-adjuvant (peri-operative) therapy followed by “curative” surgery (R0 or R1) or immediate “curative” surgery who would routinely be offered adjuvant chemotherapy.