{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T07:40:48Z","timestamp":1788680448664,"version":"build-2803163510"},"reference-count":11,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T00:00:00Z","timestamp":1739232000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U10CA180819"],"award-info":[{"award-number":["U10CA180819"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U10CA180888"],"award-info":[{"award-number":["U10CA180888"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2025,2,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Chemotherapy is required to improve the overall survival (OS) of patients with resectable pancreatic ductal adenocarcinoma (PDAC). Assessing the impact of chemotherapy dose density (DD) on survival is difficult as a result of confounding. The objective of this study was to determine the impact of chemotherapy DD on OS in patients with resectable PDAC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a secondary analysis of SWOG 1505, a randomized phase 2 trial of perioperative chemotherapy in resectable PDAC. DD was defined as the percentage of chemotherapy dose received of the total planned. Two landmark time points for OS were used: after surgery and at 40 weeks (which encompassed the entire treatment period).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 102 eligible patients enrolled, 73 (71%) underwent surgery, and median preoperative chemotherapy DD was 89%. Patients with \u226585% DD had higher OS compared to those with &lt;85% DD (median, 38.1 vs. 17.2 months; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.039). Of the 82 patients who survived to 40 weeks postrandomization, 67 underwent surgery, and median DD for all perioperative chemotherapy was 67%. In this cohort, DD\u00a0\u226570% was associated with better OS (median, 32.2 vs. 14.0 months; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.017). Perioperative DD was not significantly associated with pathologic response, margin status, or lymph node negativity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This is the first study to identify a prognostic association of chemotherapy DD with OS in patients undergoing perioperative chemotherapy and surgery for resectable PDAC. Patients who received \u226585% DD preoperatively and\/or \u226570% DD perioperatively survived longer than those receiving a smaller proportion of protocol therapy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.35759","type":"journal-article","created":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T11:49:21Z","timestamp":1739274561000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Chemotherapy dose density is prognostic for overall survival in patients with resectable pancreas cancer: A landmark analysis of SWOG 1505"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6442-1857","authenticated-orcid":false,"given":"Sameer H.","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Surgery University of Cincinnati College of Medicine  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Colby","sequence":"additional","affiliation":[{"name":"SWOG Statistical and Data Management Center Fred Hutchinson Cancer Center University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davendra","family":"Sohal","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology University of Cincinnati College of Medicine  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine A.","family":"Guthrie","sequence":"additional","affiliation":[{"name":"SWOG Statistical and Data Management Center Fred Hutchinson Cancer Center University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa A.","family":"Kachnic","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Columbia University Irving Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. Gabriela","family":"Chiorean","sequence":"additional","affiliation":[{"name":"Department of Medicine Fred Hutchinson Cancer Center University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7106-0735","authenticated-orcid":false,"given":"Andrew M.","family":"Lowy","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology University of California San Diego La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavio G.","family":"Rocha","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology Knight Cancer Institute Oregon Health and Science University  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard S.","family":"Hochster","sequence":"additional","affiliation":[{"name":"Gastrointestinal Oncology Rutgers Cancer Institute of New Jersey  New Brunswick New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip A.","family":"Philip","sequence":"additional","affiliation":[{"name":"Oncology and Pharmacology, Wayne State University School of Medicine  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed A.","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Cincinnati College of Medicine  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,11]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Surveillance, Epidemiology, and End Results Program","author":"Cancer Stat Facts: Pancreatic Cancer"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa1809775"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.279201"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(16)32409\u20106"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(16)30583\u20109"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010022\u201011363\u20100"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/sla.0000000000005830"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2020.7328"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2016.1137"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.suronc.2020.08.031"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010023\u201013353\u20102"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.35759","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T11:43:48Z","timestamp":1760269428000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.35759"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,11]]},"references-count":11,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,2,15]]}},"alternative-id":["10.1002\/cncr.35759"],"URL":"https:\/\/doi.org\/10.1002\/cncr.35759","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"value":"0008-543X","type":"print"},{"value":"1097-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,11]]},"assertion":[{"value":"2024-08-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e35759"}}